Editor’s Corner �� 2 MCES Mental Health Parity ...... 3 A Tree for Tony ...... 4 New Directions’ Loved Ones’ Group ...... 4 Compass Interview: Stephen Stahl of New Hope ...... 5 Helping kids cope with parent’s mental illness ...... 6 Being a Better Mom by Jeanine ...... 7 The Old Man and the Mirror by Evan Kaplan ...... 8 Funny Face by Eve Maslin ...... 9 To Be or Not to Be by Judy Kroll ...... 9 What to Do with Victoria? by Norman Cotterell, PhD ...... 12 Latif: 20 Years a Prisoner by Ruth Z. Deming ...... 14 Uncle Bernie’s Kitchen by Bernie Samuels ...... 17 News Roundup ...... 18 “Brain and Behavior” Research Findings ...... 23 Side Effects of Antidepressants by Rajnish Mago, MD ...... 24 Neuromodulation: Non-Pharmacologist Approach to Treating Depression by Terrence Boyadjis, MD . . 26 Neuromodulation: The New TNS by Ian Cook, MD ...... 27 Catching Up ...... 28 Dear Lithium by Hailey James ...... 29 Depression Hurts by Ling ...... 30 The PSTD Experience: Three Stories ...... 31 An American in Iraq by Phil Nerges ...... 31 I Married Trouble by Jill ...... 33 Tale of Loss and Trauma by Iris Arenson-Fuller ...... 34 Bad Diseases Happen to Good People by Jan ...... 37 How to Achieve Better Quality Sleep by Larry DiBello, RPhd ...... 39 What They’re Reading ...... 41 Pursue the Wonderful: Wildflowers by Carolyn Constable ...... 41 KaleidoScope ...... 43 Four poems by Cynthia Marcolina ...... 43 Three poems by David A. Barnitz Kime ...... 44 Life with Blue Glass by Iris Arenson-Fuller ...... 46 Two poems by Ruth Z. Deming ...... 47 Three poems by Martha Hunter ...... 49 A Parent’s Prayer by Martha Hunter ...... 50 The Cheerleader by Carly Brown ...... 51 Three poems by Allan M. Heller ...... 51 Three poems by Linda Barrett ...... 54 Two by Frank Kelso Wolfe ...... 55 Two by Craig L. Slingluff ...... 56 Photo of Coffeeshop Writers’ Group in Willow Grove, PA ...... Inside Back Cover EDITOR’S CORNER topic is yoga, meditation, or helping caregivers take care of themselves - are part of our holistic by Ruth Z. Deming, MGPGP, Founder/Director, tradition. New Directions Support Group, Abington, PA Especially dear to my heart are nutritionists who speak to us. It’s no secret that psych meds The times they are cause weight gain or that your food intake a’changing. And thank becomes part of a healthy – or unhealthy - you. goodness for that. Medication We partner with Mary Ann Moylen, nutritionist, is no longer forever. But, at the Willow Grove Giant Food Store. Make an please, stay on your meds! appointment with her – it’s free! - and she’ll walk Simply explore the possibility you around the store and help you select healthy with your psychiatrist. And and delicious foods. Call her at 215-784-1960. dream that some day, after you’re older and have Her favorite snack is peanut butter on whole- a history of knowing yourself and your triggers, grain crackers. you may very well be free from medication. Half Because I have insulin-dependent diabetes - a dozen people in New Directions, including a side effect from my kidney antirejection meds myself, are med-free without a hitch. – I lost kidney function from taking lithium for 2013 saw important victories on the legislative nearly 17 years - I’ve learned to eat healthy and front. In a narrow decision, The Supreme Court to avoid eating too many Thin Mints. Late at made gay marriage legal, but only in states night on PBS, family doctor Joel Fuhrman, MD, where it was not banned. preaches about avoiding fad diets and eating And President Obama won a hard-fought healthy foods for a lifetime. victory in the passage of the Affordable Care I follow his teachings about GOMBS, an Act, also known as “Obamacare.” acronym for Greens (such as spinach or kale), “It took a hundred years for us to even get to Onions, Mushrooms, Berries and Seeds. the point where we could start talking about and For breakfast, when I have time to chew – implementing a law to make sure everybody got and it takes a good 15 minutes - I make a salad health insurance,” said the president. with spinach, blueberries, green scallions, multi- America finally and painfully climbed on colored peppers, sunflower seeds, pumpkin board to join nations who offer universal health seeds and pecans, topped with fresh lemon juice care, such as Canada, Great Britain, the Nordic and olive oil. Chockfull of antioxidants, which countries, Western Europe, most of South help fight cancer. America, Asia, and Russia, which, as the former And in these snow-covered wintry days, I Soviet Union, was the first to offer health care keep two dozen eggs in the fridge. Nothing more coverage in 1937. delicious than a scrambled egg with mushrooms Hopefully this will ensure that no more and green scallions. families need to bankrupt themselves and lose Start young, in your twenties, to make their homes and their savings because of the healthy eating a habit. Read food labels. Avoid high cost of insurance, especially for previous the American Way of too much salt and sugar. conditions. We’ve all heard the horror stories Instead of salt, experiment with seasonings – of cancer patients dying because they couldn’t turmeric, curry powder, cinnamon – and sit down afford treatment. Unconscionable in this nation and eat with your family, no phones allowed at where cancer can be successfully treated and the sacred table. even cured! Over the Christmas holidays I did something Since our inception in 1986, New Directions new and daring. I hosted a 17-year-old Chinese has had an impressive list of monthly guest exchange student for two weeks in my Willow speakers, including two women who helped Grove home. Yuan Li – called “Bruce” – taught explain the complexities of the Affordable Care me as much as I did him. On vacation from La Act. Our informative speakers – whether their Salle College High School in Wyndmoor, he

Page 2 - The Compass SPRING 2014 showed me the YouTube video “Tank Man” about Montgomery County a Chinese citizen who stood in front of an armed Emergency Service of tank during the 1989 uprising in Tiananmen Square. The crowd roared its approval and the Norristown, PA, tank stopped in its tracks. What happened to Lauds Mental Health “Tank Man” afterward remains a mystery. Parity Rules. How about trying something new in 2014? Think a moment. What have you always wanted Nov. 8, 2013 may someday be known as to do but never had the courage? As Rabbi Hillel “Mental Health Parity Day.” It was an auspicious said in 32 BC, “If not now, when?” occasion in the domain of mental health as the Obama Administration spelled out that equal Our Ellen Rosenberg packed her bags and coverage for mental health and substance abuse flew to Bali, northwest treatment on most insurance plans will be the of Australia. She teaches law of the land. English to first-grade The announcement was made by Health and students, visits colorful Human Services Secretary Kathleen Sebelius Hindu shrines, wades in at the Rosalynn Carter Symposium on Mental the Indian Ocean and Health Policy in Atlanta. The Former First Lady helped out at a wedding. has been a staunch advocate on behalf of mental This annual issue of health for decades and was emotional during The Compass features a Sec. Sebelius’ momentous announcement. host of truly exciting and “This is a big victory, not just a tangible one, inspirational stories. “Getting better, getting but a moral one,” said MCES CEO Bill Myers. stronger, living a good life” is the theme. “Why should people be put in a position where This entire issue will be posted on our website there are more barriers to seeking treatment for NewDirectionsSupport.org, along with more major depression than for a back injury?” information about our contributors. Formerly, many insurance plans would pay a Come see us at New Directions sometime. We vastly greater percentage – sometimes as high as offer a Top Doc/Top Therapist List, small group 80 percent – of the costs for medical care but only discussions for Depression and Bipolar, led by 50 percent of mental health care claims. Those in people who have “lived the illness,” – including need of inpatient mental health treatment often Ada Moss Fleisher and Helen Kirschner - and an had fewer days covered by insurance than if they outstanding Family and Loved Ones Group, led required inpatient treatment for a medical ailment. by Carole and Gregory Hodges. Individuals with mental health needs were How did we all come together? How did being essentially penalized for attending to their these amazing individuals – who help us become psychiatric treatment needs. Now, most insurance our “best selves” – find us and make us who we companies are required to provide equal are? Is it as saxophonist Pharaoh Sanders sings in coverage for physical and mental health, which his “The Creator Has a Master Plan?” many consumers, experts and advocates see as a big step forward in terms of reducing stigma and However you find us, we’ll have a name tag encouraging adherence to treatment, or seeking ready for you when you show up at our large treatment for mental health in the first place. family we call New Directions. The Mental Health Parity Law was passed in New Directions, founded by Ruth Deming in 1986, 2008, but it did not apply to people with smaller meets the first and third Tuesday evenings of the month health plans. After the passage, psychiatric pre- at Abington Presbyterian Church; and the second and authorizations for care were still required by fourth Thursday mornings at the Willow Grove Giant Supermarket, Second Floor Classroom. We also host some insurance companies, which is no longer special programs throughout the month. See our website permitted. (Montgomery County Emergency at NewDirectionsSupport.org. Call 215-659-2366. Services, Norristown, PA, 11-8-13.)

SPRING 2014 The Compass - Page 3 Presbyterian Church, our Loved Ones’ Group meets in the back of the room, in the large library, whose double-doors close. It’s always a relief when we, in our Bipolar or Depression groups, which meet on opposite sides of the room, hear the Family Members’ laughing, as they often have a tough time. Here are some of the often dire concerns they address at every meeting: …Noncompliance of medication …Going through manic episodes A TREE FOR TONY …Calling the police on a loved one Michael and Elizabeth Garofalo presided over …The uncertainty of how the police will handle the ceremony in memory of Michael’s beloved the situation brother, Anthony “Tony” Garofalo (1965-2011) …Financial drain on family, as they don’t at Pennypack Ecological Restoration Trust in have a job and need expensive meds and Huntingdon Valley, PA. New Directions was treatment proud to plant a tree in memory of Tony, a fine …Can’t get a “soon enough” appointment sportsman and a man who everyone loved. with the psychiatrist Brother Michael embedded a tennis ball in the …Are they using illegal drugs or drinking? deer-proofing fence around the Ironwood Tree. …Parenting issues Tony’s nephews, Garrett and Stefano, are The joke is, “Don’t get sick in the summertime. in the first row. About 40 people attended the The doctors are all on vacation.” event, including friends Ada and Rich Fleisher, New Directions maintains a list of “Top Jack Finelli, Scott Sherman and Ruth Deming. Psychiatrists and Top Therapists,” essential to Tony loved hiking in the Pennypack. Our Sunday the patients’ wellbeing. Everyone is apprised of Hikes often take place in this 812-acre park this, since a good psychiatrist is one of the most replete with deer, wild turkeys, and birds of every important ingredients in a person’s recovery. kind. Loved ones have fears about their children. Parents or spouses may be afraid of their loved one when they get manic. They may become NEW DIRECTIONS IS combative or use poor judgment, whether using UNIQUE: We have a Family the credit card, shoplifting, sleeping around or Members’ Group, who meet even disappearing for a couple of days. at the same time as our On the other hand, depressed individuals may Depression and Bipolar Groups try to take their own lives. There’s a lot of fear and guilt that loved ones by Ruth Deming face. Since our inception in 1986, we’ve always The best thing about our Loved Ones’ group had a family member group. When we first met is that you can talk about anything and that in my Upper Moreland, PA, apartment, couples everyone understands. Valuable resources, such or roommates would arrive together. We’d all sit as best psychiatric hospitals and day programs, and talk for hours in the living room while the cars are shared. Most people “on the outside” have on the nearby Pennsylvania Turnpike gleamed in no understanding of this. People attend for their the sun. own group therapy and a need to talk and be Today, in our huge room at Abington understood. aaaaaaaaaaaaaaaaaaaaaaaaaaa

Page 4 - The Compass SPRING 2014 COMPASS INTERVIEW Stahl trained with the best. A Philadelphia native, he studied at The Hedgerow Theatre Stephen Stahl: First in Rose Valley, PA, then moved to Manhattan Man of New Hope to study theater directing with the renowned Lee Strasberg, known as the “father of method Stephen Stahl of New acting.” Strasberg’s students included Anne Hope, PA, and his partner Bancroft, Paul Newman and Marilyn Monroe. Robert Seneca, were the Strasberg never gave compliments, said first gay people to apply Stahl. His criticism was so constructive, though, for a marriage license in “it allowed you to see into yourself and I gained Pennsylvania. It was October, artistic trust within myself. Creativity is always 2004. Their application was within you, your own natural knowing. You need rejected, said Stahl, who remembers a bevy of to trust yourself.” photographers, eager to write about this historic Bolstered by studying with one of the greatest event. teachers of our time, Stahl – who also teaches After the rejection, “We had 10 different acting classes - went on to write, produce, and lawyers representing us for free,” he said. direct over 150 shows in 30 years. The couple was now being sued by a dozen On his website – StephenStahl.com – Stahl’s Republican Pennsylvania state representatives. musical “Tallulah” about the then-popular The case was thrown out of court. darling of film and stage Tallulah Bankhead, is In a statement to the Philadelphia Inquirer, reviewed by the Inquirer. Although the reviewer Stahl and Seneca called the judge’s decision, isn’t thrilled with the female lead, he says that “a victory not only for the gay and lesbian she is “expertly coached by director Stephen community, but for all Pennsylvanians.” Stahl” and refers to his “imaginative and well- Although the marriage broke up, Stahl, who staged production.” is 65, has a new partner and continues to lead His inventive website features film clips of an exciting life as an actor, theater producer and shows such as “Sister Mary Ignatius Explains It director. All for You,” which starred Mink Stole, an actress “Mr. Stahl has directed some of the best who has performed in every film by cult filmmaker works ever seen on the Philadelphia stages,” John Waters of “Hairspray” fame. wrote the Inquirer. Stahl’s independent film feature The flamboyant, white-haired Stahl, who “Consequences” won the Los Angeles resembles a movie star himself, is coming off International Independent Film and Video the “high” of his latest off-Broadway play. The Festivals’ award for best thriller feature in 2006. musical “Lady Day,” starred Tony-award-winner When the film showed on the East Coast, Stahl Dee Dee Bridgewater as the much-loved jazz received Best Director of a feature film. singer Billie Holiday. The show will now travel Hard to believe, but Stephen Stahl, whose around the country and on to Europe. Facebook page is alive with sentimental “It’s a lifelong dream to bring this show to responses – he has nearly 5,000 friends – such as New York,” said Stahl in a statement in the New “You are in my heart forever. Love you as well” York Times. – was a difficult child. “From the age of 8, my Written and directed by Stahl, the show parents took me to doctor after doctor, trying to cost $2 million to produce off-Broadway, where get answers. I was finally diagnosed with bipolar theaters seat up to 499 people. “Lady Day” was disorder and was on medication.” held at the Little Schubert Theatre. He no longer needs medication for bipolar. “The same show would cost between $12 and The lure of drugs plagued Stahl over the $14 million for one additional seat in a Broadway years, as it did his “Lady Day” – Billie Holliday - theater,” said Stahl. who was a long-time heroin user. Stahl has been

SPRING 2014 The Compass - Page 5 clean and sober – never touching cocaine or even coffee.” a celebratory glass of champagne - for 11 years. If only Grandpop Max could see his little He attends 12-Step meetings five times a Stevie now. He and Robert live in a magnificent week at 7 a.m., a reminder that cocaine nearly carriage house - built in 1817 – that spans an killed him. “In the ‘90s, I blew my heart out, had acre and a half, right in the center of town, a massive heart attack. Today I walk around with although, said Stahl, “It feels like we’re deep in a defibrillator.” He laughed and said it’s time to the country.” get new batteries. The interior is furnished in “country English Stahl and his partner Bob Ebert, 34, live in a with warm brown and burgundy walls” where art carriage house in New Hope. Ebert manages the work, from Dali to Warhol, delights visitors. Golden Plough Inn in Lahaska. They met at the “Many mornings, we open the door to hordes now-defunct Cartwheel Club in New Hope. of deer,” said Stahl. Stahl knew he was gay since the age of 8. Stahl’s “office” is The Starbucks in New Hope, “I felt secure and safe with my feelings and a brick building that also houses a bank. On any never tried to hide it from anyone. My family was given day, you’ll find him holding court, sipping completely supportive from the start. on his Venti Blonde Black coffee. On the day of “Interestingly,” he continued, “I was married our interview in mid-January, he’ll meet his agent to women twice and have two children and three there to discuss plans to bring “Lady Day” to a grandchildren.” He always makes time to see his wider audience. family. Perhaps when Lady Day co-wrote “God Bless “My goals for the New Year,” said Stahl, “are this Child,” she was crooning it for one of her to keep working and to be the best person I can greatest fans, Stephen Maximillion Stahl. possibly be. I have faith in a power greater than me!” Helping Kids Cope with For sure, one of these greater powers is Parent’s Mental Illness.” his late maternal grandfather, Maximillion Goldstein. In his childhood, Stahl’s large Jewish “Child and Family Connections” was family – including 15 children - would vacation co-founded by Evan Kaplan, a 44-year-old on the beach in Ventnor, NJ, setting up camp. Philadelphian who has bipolar disorder, to help They slept in tents where they could feel the cool people with mental illnesses be better parents. ocean breezes. He and co-founder Loran Kundra developed “This is hard to believe,” said Stahl, “but my a free evening workshop of classes aimed at grandfather met Walt Disney on the beach.” improving communication within the family Disney, originally from Chicago, met grandfather and bolstering children’s resilience. Temple University’s Collaborative on Community Max Goldstein while the Atlantic Ocean Inclusion is a co-sponsor. glimmered behind them. They got to talking. Though Kaplan had been hospitalized many And brainstorming. times for bipolar disorder, he was surprised The two of them came up with the idea of a three years ago to learn that his then 9-year-old character, “Steamboat Willie,” who later became daughter knew he had a mental illness. That set Mickey Mouse. Disney repeatedly asked Max him on a path to eventually give up a previous to move with his family to California, but Max career, found the organization and begin leading Goldstein refused. the classes. “He was smitten with my grandmother Rose,” Topics include factors that help build said Stahl. He had just met her and refused to resilience in children, such as a strong support leave the East Coast where the relatives lived. system. Parents talk about creating a back-up “She was not an easy woman,” he remembered, plan for their children when they need to go into “but my grandfather adored her. Every day of the hospital, and each writes a letter to a child her life, he bought her a fresh rose and a cup of explaining the mental illness. Helping people

Page 6 - The Compass SPRING 2014 with mental illnesses be better parents can speed 4-year college. It has everything on it – all the their own recovery, while helping their children people involved in the class. better understand their parent’s behavior and, It was a great education for me. I learned a ultimately, be emotionally healthier as they grow lot of new words. I felt I was not alone. up. The class was free, sponsored by Temple In response to Kaplan’s daughter Charlotte’s University Collaborative on Community Inclusion wish that she could talk to other kids whose of Individuals with Psychiatric Disabilities. parents have mental illnesses, Child and Family They give you a binder and a book called Connections is now working with Einstein “I’m Not Alone: A Teen’s Guide to Living with Healthcare Network to offer a multi-week a Parent who has a Mental Illness.” A mother workshop for parents and children together. and daughter put the book together: Michelle Sherman and DeeAnn Sherman. Article from the Philadelphia Inquirer, 8-4-2013.

It’s a workshop type of book with exercises and BEING A BETTER MOM a lot of resources such as WRAP, the Wellness by “Jeanine” from New Directions Recovery Action Plan. I got to know the people in the class during My main priority in life is my son Danny. (All the four weeks and had a lot of examples on how names have been changed.) He’s a really smart to care for my child. 5-year-old but he lives with a lot of chaos. His I didn’t talk too much. I listened. I went father and I live together and argue all the time. because I needed to learn how to deal better The dad, sadly, is an alcoholic, and Danny has with my reactions. My diagnosis is bipolar one. abandonment issues because of his father. The Every day I work on myself. dad and I continue to live together, here in Again, his dad is in and out of his life. It’s Pennsylvania. I want to move in with my family tough on Danny. There is no peace at our house. in New Jersey but need an order from the judge You can’t have a parent who’s on one track and that it’s okay. We have joint custody. the other on another track. I took a wonderful four-week workshop called During the last 12 months, I’ve had a lot of “Parenting with a Mental Illness.” help with parenting. I get family-based therapy I met the chief executive, Evan Kaplan, who where they come out to the house. I attend New shared his own experiences on being a parent, Directions’ meetings. But all the father sees is as did Melody Jackson, the lead facilitator. that I’m to blame. He and his family do not take The class was well-attended. About 30 responsibility. people. You wear nametags, just like at New The father is usually at his family’s house, Directions. You don’t feel alone. It’s your option which is good because there’s always fighting, to say your name and why you’ve come. arguing and cursing here. I’m trying to get The first class featured a movie with puppets. Danny out. There’s very little structure here with The puppets talked about why the kid had to the father coming and going when he pleases. stay with a relative: because the parent had a On a whim, he bought a puppy. mental illness and was seeking help. Evan Kaplan was a great, honest, warm, down- Danny and I went to the first class because to-earth host. He shared about his daughter. I didn’t have a baby-sitter. He was fine but the They call it “Road to Recovery.” You finally get class is for adults. to the point where the meds are working. Before Snacks were served: candies, doughnuts, it was all madness and chaos. soda, and cake on the last day when we I can take a refresher course, which I’d like. graduated. I’m on public assistance for now and looking for They gave me a beautiful certificate which a job. I have everybody helping me. has the seal of Temple University: Certificate It makes me feel better about myself that I of Achievement. It’s like you graduated from a did all these things.

SPRING 2014 The Compass - Page 7 Danny is in kindergarten now and likes it. He by the fantasy of stepping back in time, rewriting also qualifies for a full-day enrichment program the course of my history by averting some of the at Penn Valley’s Montgomery Early Learning hardships, losses, and pain that my mental illness Center. My Aunt Eileen found out about it. We has contributed to these 45 years. get a discount with government funding. If I wound the clock back a dozen years, Hopefully we’ll move in with Aunt Eileen and I’d be wandering the streets of Kensington, a other members of my family. There’s more love seedy underbelly of Philadelphia, broke, nearly and support there. Everyone is under one roof. homeless, and wary of the drug dealers, hookers, I’m getting legal advice from a Women’s and con men who populated every corner. Or Resource Center. I thank everyone at New I might jump back further, to the 14 months Directions and all the people who put me in all in which I was institutionalized at an in-patient the right places. Instead of thinking inside the treatment facility, hopeless that I’d never leave. box, I’m thinking outside the box now. I’d devised a way to fly down to Miami with the sole intention of killing myself. I can still hear the shriek of the hotel maids when they found me lying in a pool of my own blood amidst a kaleidoscope of broken glass. Earlier still, I’d see the man in his early thirties, recently diagnosed with Bipolar I, a first-time father whose mania, exacerbated by self-medication, had already destroyed a successful business and was eating its way through his marriage. Had I touched down there I might have avoided the dozen psychiatric hospitalizations, electroconvulsive therapy that left me drooling and even more depressed, and the botched suicide attempt that put me in a coma. THE OLD MAN AND However, to truly undo the damage, I should THE MIRROR skip my college years and early twenties, which were marked by bouts of bottomless depression by Evan Kaplan during which I remained locked in my room for Executive Director of the Child and Family days, forfeiting the pretty girlfriend who finally Connections Philadelphia gave up. I’d pass the sullen teenager awkward Perhaps in spite of, or maybe because of the and alone and so ashamed, wishing he had fistful of psychotropic medications—Wellbutrin, never been born. No—to truly change my life, I’d Vyvanse, Effexor, Lamictal, Sonata, and a half a need to meet the young boy, no older than six or dozen other pills—I take vigilantly twice a day, seven, a time of confusion and chaos, anxiously my dreams often involve my bipolar disorder and awaiting the next eruption of feelings that got attention deficit disorder. In one such dream, a him in trouble so often. little old man, a stranger, disheveled and smelling This young boy was acutely aware that of vinegar, stopped me in the street and nodded something was “wrong” with him but silenced at his outstretched hand. He held out a small by his lack of vocabulary or the courage to square mirror, smudged with dirty fingerprints. express it. But mental illness is, as the experts He said if I were to look into it, it would return tell us, genetically rooted in our family tree, I’d me to any time in my past. He cautioned it would need to start from the beginning, to have been only work once and I must choose carefully, for born the son of another family, for mine lives in a it would irrevocably change the course of my forest of wilted weeping willows. Yes, only a full life. The dream was disturbing and I remember rebirth could refurbish the failed relationships, nothing more. But the next few days, the old man the estrangement from my young daughter, and his mirror stayed with me—I was enchanted the heartache, and the guilt that so many of us

Page 8 - The Compass SPRING 2014 shoulder throughout our lives. It might have even medication and how it made me feel, teaching saved my loving family from the grief and guilt her the correct words and labels for our feelings, (and expense) of having a child who is mentally ill. and sharing age-appropriate stories about my life. Had I accepted the old man’s offer, my then And I always, always, always reassured her that I nine year-old daughter Charlotte would not have loved her dearly. But it was an anxiety-provoking blurted out one day in family therapy, “I don’t and frustrating process. Just because I was ready like the decisions my daddy makes because he to talk about it didn’t mean that Charlotte—with has a mental illness!” The unadulterated pitch of her nine year-old’s attention span—was. Charlotte’s voice had reverberated with anger Then one day Charlotte said to me, “Daddy, (hurt) and mistrust. I had suppressed the urge to I wish I could share my struggles with other kids yell back at her and struggled to hold back the who have a parent with a mental illness.” tears (which would flow later and often). The world suddenly melted away as I realized The therapist and I had stared in disbelief: how far we had come, father and daughter. The Charlotte had already known about my mental process of talking about and learning about illness! It was of no matter whether they were her mental illness together, my willingness to be own words or those gleaned from elsewhere— vulnerable, her unconditional love for me, and her feelings were very real. In that moment, our mutual honesty had brought us closer than my understanding of our relationship changed we’d ever been, and it had helped rebuild the forever. I had missed a once-in-a-lifetime trust I had allowed my mental illness to erode. opportunity to be the first person to talk to my Later on, I even discovered that clinical research daughter about my mental illness. bore out what I had experienced firsthand: Sure, I had rather benignly talked to her about talking about mental illness with children has the daddy’s “health issues,” but never specifically power to heal and build resiliency and strength, about my mental illness. She was too young and that it’s never too late to start. and the topic too “complicated,” I reasoned. Since starting Child and Family Connections, But not only had my logic been flawed, it had a nonprofit that teaches families how to talk also been dishonest. The truth was, I had been about parental mental illness in ways that build afraid. I had been afraid to talk to my daughter trust and foster childhood and family resiliency, about my mental illness due to my pride, fear of my life (and my psychiatric disability) has in many her disapproval, and shame—especially shame. ways become more, not less difficult. Yes, there (Yes, even those of us with psychiatric disabilities have still been hospitalizations and many days sometimes fall prey to stigma.) My mute silence when I don’t leave the house, but I am energized had eroded trust and created a wall between and comforted by my work and the people with Charlotte and me. It had also opened the door whom I work. And my relationship with Charlotte for nameless other people to “educate” her. has continued to blossom. I’m finally proud of Over the course of several more therapy who I am, disability and all. And so is my daughter. sessions, we discovered that Charlotte’s outburst Tell the old man to put his mirror back in his was the result of a misunderstanding and pocket. some misinformation. There were gaps in her knowledge about mental illness, and as children Evan Kaplan is the Executive Director of Child and Family do, she had devised well-meaning but misguided Connections (CFC). Inspired by a disturbing disclosure from explanations. his daughter, Evan journeyed from institutionalization and Over the next year, I made a conscious destitution to founding a nonprofit that supports families effort to rebuild our relationship. Charlotte and dealing with parental psychiatric disabilities. Evan draws I sometimes read articles on Wikipedia together upon his lived experience to teach other parents how to talk with their children and families about parental psychiatric and Googled famous people who had mental disabilities in ways that build trust and communication illnesses, and I also began talking to her about and foster childhood resiliency. Learn more about CFC at my bipolar disorder, explaining why I took ChildFamilyConnections.org. ccccccccccccccc

SPRING 2014 The Compass - Page 9 FUNNY FACE by Eve L. Maslin I probably won’t ever give up talk therapy, but every week, during my art class, I say something like, “This is the best therapy I have all week.” Obviously that’s only in conjunction with my medication and talk therapy. Every Friday morning, I take an adult art class in the basement studio of Sue Puchowitz in Cheltenham, PA, for two hours. I look forward In addition to cutting glass, I used glass to those two hours all week. All of us work in chips, rods and frit – this is like glass sand. I’ve different mediums of our choosing, and Sue also been making silly faces, with and without comes around giving us suggestions, pointers, hats and beards, ears and noses. Usually one eye and making our play come alive. Last year it was blinks, if you can figure that out from the mess ceramics, this year it is fused glass for me. I’ve made. All of my holiday gifts were fused glass this year. I got to have fun, use my hands and see concrete results, and save a lot of money. That’s definitely one kind of wonderful therapy. Eve Maslin lives in Elkins Park, PA, and has four grown Sue started me off in ceramics rolling the clay children. with a rolling pin. Boy, did I ever roll that clay! Eventually, I got to the point where I was ready TO BE OR NOT TO BE, to roll the clay evenly, over a platter mold, and I made a platter. The next thing I worked on was THAT IS THE QUESTION a serving dish. by Judy Kroll I started off with a rolled bottom and part of An acquaintance of mine, Joe B., committed a rolled side. You layer the sides to build a wall. the final act of his life Sunday night by ending Then Sue walked by and told me I could roll up it. He did the deed in his basement. He didn’t the snakes and make swirls. leave a note. He was 47 years- Swirls it was! Eventually all of the sides of the old and lived by himself. He left dish were there. I had so much fun with that one, behind two daughters, ages 11 I made another. In the next dish I learned how and 16, whom he loved very much to roll balls. Imagine laying cannon balls side by – they took vacations together - side to make another wall. as well as a group of caring and Rolling balls can be very therapeutic. Then I supportive friends and family made a sugar holder and a creamer. Soon I had who were willing to do anything enough clay to be fired for the first time in Sue’s to help him. He left the rest of us to speculate kiln. on the whys of it all and to come to terms with When it came out, I enjoyed the next steps: his decision. How could this seemingly senseless painting, sponging, highlighting and splotching act have been prevented? How can you prevent the glaze on my pieces before they were fired what you can’t predict, or change a person’s again. My fun ended up as a dessert set for me. distorted thinking? This year I’m working with fused glass. After They say that, “Suicide is a permanent cutting the colors of glass into pieces, I layer solution to a temporary problem.” Obviously, them and they get fused together in a small kiln. this advice didn’t do much to stop Joe from

Page 10 - The Compass SPRING 2014 going through with it. Why would someone feel Whether ‘tis nobler in the mind to suffer desperate enough to take such a permanent The slings and arrows of outrageous fortune action and not reach out for help? How much Or take arms against a sea of troubles pain was he in that he thought that suicide was And by opposing end them. his only way out? Hamlet struggles with whether or not to take Waves of shock permeated our community. his own life based on the occurrence of adverse Reactions ranged from extreme sorrow – “poor circumstances that were beyond his control. Joe,” - to anger – “he’s a selfish coward,” - to While I felt nothing but sadness for Joe, acceptance – “now he’s at peace.” Discussions of how we can prevent ourselves and others others deemed his act as selfish and cowardly. from making such a fatal choice ensued. There They judged him harshly. How could he put his were no definitive answers. family and friends through that, not to mention Joe B. always had a helping hand to lend to his daughters? As a human being I’ve often others and a smile that glistened with warmth stated that it is better to feel pain than nothing at and understanding. He appeared to be doing all. I tried to imagine Joe tying the rope around well when I sat next to him at a dinner outing his neck. It must have taken some courage to only about a month ago. He was a little down take that journey to an unknown fate that awaits. but was working through it. He was going to Haven’t all of us pondered ending it all at one outpatient therapy and appeared to be keeping time or another and contemplated which method it together. He was not one who liked asking would suit us best? Or is that just me? for help, but he was coping. Six weeks prior, he Ah, there’s the rub. Life is an unknown tried to overdose on OxyContin, was taken to journey to an unknown fate that awaits you, too. Horsham Clinic and detoxed off the pills. I heard Doesn’t it take courage to get up every day and he remarked that he couldn’t even be successful face whatever trials and tribulations that come at that. After the suicide attempt, friends stayed your way? There are good days and bad days. with him until he got back on his feet. I can’t understand how a person could give up Joe had been in a tragic motorcycle accident all hope; for that is not a choice that I see myself five years ago. Prior to that, he had been clean ever making. As long as there are sunsets to look and sober for 10 years, with the help of NA. In at, music to listen to, and friends and family who the accident, his girlfriend died and Joe lost a love me, each new day for me represents a fresh leg. Then his divorce was finalized and his father start. I have always prided myself on being able died. Friends surmised that the drugs kept him to overcome adversity. However, if things got numb and when he got to “feeling” again, the too bleak to bear for a long period of time and I pain was just too great. He had fought the good could see no positive end in sight, would I do it? fight. A doctor that I know told me that when Would I take the risk that there would be less a patient is depressed, they are too lethargic to pain on the otherside? Or would I live my life for move or take action. Once the depression gets others’ benefit? You cannot live your life just for treated, they must be watched closely, because others though, right? You must find some joy or then they have the energy and impetus to take redeeming quality in it for yourself in order to action and kill themselves. It’s a catch- 22. go on. You must realize that circumstances will My late father, Mel, suffered from depression. not always be so bleak and that things will come As I was waiting to get him admitted to Friends around. If you don’t believe that, or can’t see it Hospital, he confided to me that he didn’t want after many medications, hospitalizations, failed to live anymore. He said that the only thing relationships and health problems, is suicide a keeping him from taking his own life was the fact validly courageous choice or a coward’s way out? that children of parents who commit suicide are I guess ultimately, each individual must make 40% more likely to take their own lives. He didn’t that decision for himself. want to leave me with that legacy, so he suffered on…Now that’s pure love. Or is it? Judy Kroll, is a 47-year-old wife and mother of a 12-year- old boy. She has been managing bipolar disorder since To be, or not to be – that is the question: 1985. She lives in Holland, Bucks County, PA.

SPRING 2014 The Compass - Page 11 WHAT TO DO WITH Rejecting? Cold? Impoverished? Small? Finally, it leads us to see our future in a negative light. VICTORIA How did you see your future? Hopeless? Non- by Norman Cotterell, PhD, of existent? the Beck Institute for Cognitive Depression as hibernation: When you felt Behavior Therapy, Bala Cynwyd, depressed, what happened to your energy, your PA motivation, and your interest in life? Look upon Q: Victoria was once an active depression as a hibernation response. Your body married woman who was on psych is telling you that all your efforts are as fruitless meds, but decided to go off them. as a bear looking for food under 12 feet of snow. For a while she was fine, but then - boom! - Depression tells you to slow down, shut down, go depression hit her so terribly she was suicidal for to your cave and hibernate, hibernate, hibernate. a couple of months, as she struggled not to do The function of depression is to conserve energy, the deed. By then, her psychiatrist had put her rather than waste it on a fruitless useless pursuit. back on meds, which took a long time to kick in. And depression tells us that all efforts are useless. She says she has never been the same since Does that describe your experience? that experience. She does wish to move forward, so terribly she was suicidal for a couple of but can’t figure out how. She sees a therapist who months, as she struggled not to do the deed. she likes very much. She berates herself daily What were the disadvantages of life? What and wishes to think more positively but it seems made it seem not worth living? What were the impossible for her. She has a habit of complaining benefits of death? What made that attractive? to people. And when she complains, they always What were the disadvantages of death? What try to “fix her,” and she knows she is the only one do you stand to lose? who can fix herself. What are the benefits of life? What do you If Victoria were your patient, Dr. Cotterell, stand to gain? If I were to tap a magic wand what would you do? on your head, and depression were gone, what Victoria was once an active married woman…. would you do? What would change in your life? What hobbies, interests and activities did I’ll ask another way: I tap that magic wand on you have? What did you enjoy? What gave you your head and everything in your circumstances a sense of accomplishment? What provided is the same, except your attitude. You see meaning and purpose in your life? What qualities yourself, your world, your future in a positive attracted you to your husband? What did he do light. Your energy, motivation, and interest in life that made you feel loved and cared for? have returned. If all this occurred, what would …who was on psych meds, you do in the next week? What would you do in What were the advantages of taking the next 24 hours? medication? In the realm of Labor: How important is your work on a 1 to 10 scale? What would you like to but decided to go off them. see happen in that area? What would you like to What were the disadvantages of taking do? How important is volunteer activity? What medication? would you like to see happen there, if anything? For a while she was okay, but then - boom! - How important is self-education? What would depression hit her… you like to learn about? Depression is a liar: First, depression In the realm of Love: How important is leads us to see ourselves in a negative light. intimacy or romance? What would you like to When you felt depressed, how did you see do or experience in that area? How important is yourself? Helpless? Diminished? Inadequate? friendship? What kind of friend would you like to Out of Control? Secondly, it leads us to see our be? How important is family? What kind of son, personal world in a negative light. When you daughter, sister, brother, mother or father would felt depressed, how did you see your world? you like to be? How important is spirituality, or

Page 12 - The Compass SPRING 2014 your philosophy of life? What principles guide what we do for others, and what others do for you? What do you want your life story to be us. Pleasures can come in what we experience about? vicariously. Depression will tell you they don’t By then, her psychiatrist had put her back on count. But depression is a liar. meds, which took a long time to kick in. but it seems impossible for her. What did you attempt in order to feel better? What was your greatest accomplishment Did anything work? What made you feel better? this past month? The most difficult thing you What made you feel worse? did? Doing anything with depression, any She says she has never been the same since that valued activity, is a great accomplishment. Why? experience. Because of its difficulty. If depression had its way, What has changed in you? What remains we would spend all day and every day in bed. the same? What strengths do you have? What So, gauge success according to your actions, resources do you have? What tools, talents, not the results of your actions. You control your skills, abilities, information, advocates, family, actions. You don’t control the results. Do the friends, and professionals do you have on your right thing because it is the right thing, not side? because of any imagined future rewards. She does wish to move forward, but can’t figure She has a habit of complaining to people. And out how. when she complains, they always try to “fix her,” First, what stops you from moving forward? Are there any other disadvantages of Is it lack of motivation or energy? Are you complaining to people? If depression were lost in thought – the paralysis of analysis? Are gone, what would you talk about instead? you unaware of your options? Or don’t know and she knows she is the only one who can fix which to pick? Next, what are the benefits of herself. avoidance? Is it a way to avoid failure, never Where is the evidence that you are broken? making a mistake? Nothing ventured, nothing In what ways do you exhibit health? If you were lost? Is it a way to reduce anxiety? Next, what broken, what’s the worst that could happen? are the disadvantages of avoidance? What do The best? The most realistic? If you were you lose out on? Finally, what are the benefits of broken, what constructively could you do to “fix” getting active? Depression tells you two things: yourself? You are a bear in hibernation, and it is time to And what are the costs and benefits of go into the cave. Any activity, any movement, accepting yourself “as is”? Are there any any bit of exercise contradicts this message, and benefits in thinking of yourself as broken? Any spits in the eye of depression. costs? And what are the benefits of changing She sees a therapist who she likes very much. the metaphor, seeing yourself in a different light, What’s most helpful in therapy? What’s least as a full human being? helpful? Norman Cotterell, PhD, is Clinical Coordinator of the Beck She berates herself daily …. Institute for Cognitive Behavior Therapy in Bala Cynwyd, How does this affect you? What would you PA. He earned his A.B. in Psychology from Princeton rather do? University and his PhD from the University of Delaware. and wishes to think more positively…. He has lectured extensively in fields such as stress What was your most enjoyable activity in the management, anger and substance abuse. He treats older past month? Your most pleasurable experience? adolescents and adults with a variety of difficulties such Pleasures can come in what we see, smell, as mood disorders, substance abuse, marital distress and taste, touch, and hear. Pleasures can come in family problems.

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SPRING 2014 The Compass - Page 13 LATIF: TWENTY YEARS A took a couple of buses while I drove down to the Willow Grove Barnes and Noble. PRISONER There he was sitting in the Coffee Shop, just as by Ruth Z. Deming I remembered him. He’d gained a lot of weight, In 2004, my sister Ellen and I his scraggly beard had turned half-gray, and he were installing a display case on had a purple “prostration mark” on his forehead mental health at the Abington from touching it to the ground in Islamic prayer. Free Library in Abington, PA. Sitting with perfect posture, he towered over the “Guard my purse,” I said to table, spread with his papers and files. Ellen, as I went off to the ladies’ He had not gone straight. room. He was incarcerated on July 4, 2006 – two When I returned my pocketbook was lying on years after my Compass article - and had just the floor with the zipper open. Quickly, I found been released on Sept. 17, 2013. my red wallet and looked inside. My credit card My head spun as he told me he had spent was gone. a total of 20 years in just about every prison in I knew who did it. Three black people – an Pennsylvania and New Jersey. attractive young woman and two unkempt men It was during his last prison sentence - of five with straggly beards - had walked into the library years - that he learned that crime didn’t pay, together. Although the library is integrated, but, more importantly, he learned that crime these two men looked as if they’d never set foot was wrong. And he was genuinely sorry and in a library before. remorseful for all the identity thefts he’d gotten For some reason, instead of leaving with away with. my credit card, they were hanging around. I “I thought white-collar crime - victimless found them in the stacks and confronted them, crimes - didn’t hurt anyone. But I was wrong,” speaking to the man who was in charge, a man said Latif, whose real name is Thomas Williams. whose name was Latif. He’d been sitting at a He was never violent, he told me, but was library table and I went up to him earlier to ask a proficient thief and pickpocket, “a criminal his help in fixing a frame for the Display Case. I genius,” he said. He began as a teenager and heard his friend call him “Latif.” ran with a bad crowd. Latif – pronounced LAH-teef - is actually The shocking thing is that Thomas Williams, his Arabic name, which he received when he now 47 years-old, was from a well-to-do family in converted to Islam in prison. It means “subtle.” South Philadelphia. He wanted for nothing. With his practiced hands, Latif lifted out my We reminisced about the theft at the wallet and extracted my credit card. Abington library and he told me how a good After arguing with him in the stacks, in thief operates. whispers, his female accomplice retrieved my After extracting the credit card, he said – and credit card from her pocketbook. people usually have more than one - he leaves I asked to see them outside, where I chastised the money in the wallet. That way, people don’t them, and told them to change their lives. I told notice that anything’s been stolen. By the time the young woman, Roz, she should be in nursing they realize it and call the police, he and his school instead of hanging out with creeps like friends have already spent tens of thousands of Latif and his friend “Bugs.” dollars on items they give to their “fences.” Then I wrote up the story in the 2004 edition of they discard the credit card and find new victims, the Compass and mailed it to Latif. With all the always in the wealthy suburbs. naiveté of a ten-year-old, I believed I’d convinced Williams told me he was on parole and living them to change. in a halfway house in North Philadelphia. The Was I in for a surprise! rules were rigid and unbending, of necessity. Nine years later, in November of 2013, I “Was it terrible being in prison?” I asked. received a phone call. It was Latif. He paused. He wanted to meet with me. Next day he “No,” he said. “I deserved it.”

Page 14 - The Compass SPRING 2014 The best prison of all, he said, was Bucks his head and telling me the phone numbers of County Correctional Facility where “they treated American Express and Discovery. you like a king.” He said the food was great. I told him my daughter Sarah’s pocketbook One of his goals now is to become a chef. was stolen when she and I took a trip to Paris in Williams has two children. At 18, a one-night- November. We were in the fitting room at Morgan stand produced his daughter, Tanita, who is a et Toi clothing store in Paris. We sat in adjoining 29-year-old pediatrician at Children’s Hospital of fitting rooms and Sarah got up for 60 seconds Philadelphia. to exchange sizes and when she returned her He now has his first granddaughter Tamia, pocketbook was gone. who is almost 2. He showed me her photo on his A perfect opportunity, he said, and advised parole-mandated cell phone. “Never leave your purse or backpack on the Looking toward the entrance of Barnes and back of a chair. Too easy to take.” Noble, Williams said he could go into any store, “My backpack is on the floor under the table watch who was entering, and know immediately now,” I said as we sat at the table. “Is it safe?” if they were there to steal. “You should keep your foot on it at all times,” “You watch what they carry inside the store,” he said. he said. Williams was productive during his last He’d like to give presentations to Macy’s and prison stay, where he was transferred to several other stores on how to foil thieves. Pennsylvania and New Jersey prisons. The Coffee Shop, he said, is the perfect place He wrote his autobiography and showed me to steal credit cards. He used to stick out his stacks and stacks of notebooks he wrote. One umbrella, grab someone’s backpack, get a couple volume was called “Memoir of a Lunatic.” credit cards, and then return the backpack to the He told me all the famous people he met in owner who never knew a thing. prison, serial killers like Gary Heidnik, who was At a store such as Macy’s, he would rummage executed, and famous mobsters. in the waste basket behind the counter and grab He knew them all, rubbed shoulders with a handful of receipts. Then he would activate them in the exercise yard or at meals. Some of the credit cards, call the banks and through an his friends were executed. Others died by natural automated message would learn how much causes. money he could spend. “Ten of my friends died in prison,” he said. He would have accomplices waiting for him These were real friends and he missed them. in a getaway car when he bought Rolex watches, When someone dies, the prison rings a bell. fur coats, or expensive jewelry. “That’s how you know they died. No one should He would then sell the stolen items at cheaper be treated that way,” he said. prices to a list of people who were waiting for his In prison, he was in the exercise yard doing stolen merchandise. pushups and a friend of his had a heart attack He would open new credit card accounts in right there next to him. He was taken away. the names of the people whose cards he had Williams never knew what became of him until stolen. He reeled off the occupations of people the next day. whose cards he had stolen. The bell rang. ”Stuff!” I said. “Do you want all those riches We all know prisons are rife with corruption. today?” But what he told me was like watching a horrible I believed him when he said he did not. movie. While in prison, his head was stuffed with Inmates, said Williams, are strangled by guards information about credit cards, the way an or beaten to death. The guard calls out, “Stop imprisoned doctor remembers how to diagnose resisting” and then clubs the person to death.” and treat. A friend of his lived through a beating and “The whole time I was in prison - 20 years was barely recognizable afterward. - I kept the phone numbers of the credit card Some female guards are available for paid companies inside my head,” he said, touching sex.

SPRING 2014 The Compass - Page 15 Let’s say Lola is the guard and Sam wants the will lie to have you convicted of a crime you had sex. nothing to do with.” They might attribute words Lola’s friend will meet Sam’s friend at, say, that an accomplice said to you or say they saw Barnes and Noble. The friend will give Lola’s you on a video camera when it wasn’t you. Some friend $300. This is also the way drugs are people just plead guilty and say, ‘Oh well, they smuggled into the prison. got me.’” Only one person visited him when he was in Last week Williams was out of his halfway jail. His sister Phyllis. When he was released, she house at 7 in the morning looking for work. took him to the Warwick Hotel in Philadelphia When he returned at 7 in the night, his parole where he dined on prime rib - a $56 meal. officer was waiting for him. I had brought Williams a red poinsettia to She was about to leave since she’d been take back to his halfway house. waiting a couple of hours. “We’re not allowed to bring anything into the “You’re out of here, buddy,” she told him. house,” he said. He thought he was being transferred to The following day was Thanksgiving. Williams another halfway house. would be penalized by staying out beyond the “You’re a free man,” she said. curfew – because he met me and it’s a very long “Impossible,” he said and told her how much bus ride - so he’d stay inside at his North Philly time he still had left: four years. rehab. Unbeknownst to Williams when he was “Would you accept something from me?” I “upstate” at Graterford Prison and had asked, offering him a $20 bill. filed numerous motions citing prosecutorial “Yes,” he said. “I’ll buy my bus pass with it.” misconduct, blatant lies and deception, the He also wanted to buy his granddaughter a judge agreed with him. gift. He only works two days a week as a cook “Your filing was granted,” said the parole but has submitted dozens of job applications. officer. “You’re a free man.” One hope is to find a job through the mayor’s Packing his bags, he left the halfway house program to find jobs for ex-felons, which, in and walked into the dark night of Philadelphia, turn, is part of a Federal program endorsed by a free man. Attorney General Eric Holder. Williams called me on January 22. “I have He’s now staying with relatives in Logan. news for you, Mrs. Deming,” he said. Free at last, Thomas Williams is catching up While in prison, he had become his own with life. “jailhouse lawyer.” He visits his daughter Tanita and “Instead of just laying around doing nothing, granddaughter Tamia every weekend. They go I studied criminal law. I started to fight my way out to eat. out of prison because I was sentenced to a total At night he reads, but only Islamic literature. of 18 years. In my mind that was too much time, His current book is “Spiritual Diseases and so I read my Discovery (all the evidence the Their Cures,” by Ibn Qayyim Al-Jawziyya. This District Attorney has against you) and I saw some renowned Islamic scholar, an Arab Sunni, born lies, I saw some deceit on the part of the state in 1292, is known as “The Scholar of the Heart.” prosecutor, so I filed a PCRA, which is a motion And what of his former accomplices? Roz is to get me back in court and in front of the judge. doing well, he said. She’s working. Not so for “I wasn’t dissatisfied that I was convicted. I “Bugs.” All was well but then he broke parole was dissatisfied that they gave me so much time and landed up back in Graterford. – and that they were trying to take time away Thomas interviewed with the Water Works of from me that they owed me.” Philadelphia. He desperately needs the money Williams read about 60 to 70 books on as he wants to have an apartment of his own. criminal law, State and Federal law and with that, Most of all, though, he wants to give talks in the “I came up with my way out of jail. wealthy suburbs on how to avoid identity theft ”Don’t be mistaken,” he said. “The by one who knows best: the former criminal prosecutors, the police officers, and detectives mastermind Thomas “Latif” Williams.

Page 16 - The Compass SPRING 2014 UNCLE BERNIE’S KITCHEN BERNIE’S GARLIC WHITE SAUCE for PASTA You would never know by looking at them For one pound of pasta (try using curly pasta for that Bernie and Freda Samuels of Warrington, a change although any pasta will be good) PA, are the youngest octogenarians you’ve ever met. Perhaps it’s their positive attitudes toward Ingredients life, their love of each other and of learning. 1 head garlic – chopped – a head means the They exercise daily, taking their standard poodle, entire bulb Lucy, for walks in the park. They eat healthy, and ½ cup olive oil when they read about someone interesting in ½ cup white wine the paper, they invite them over for lunch. That’s 2-3 pinches salt how they met their good friend, Ruth Deming. ½ bunch parsley –fresh-chopped or 3 tbsp. dried

Process BERNIE’S CHICKEN or FISH Earlier in the day or on the night before: & VEGETABLE BAKE add chopped garlic and salt to ½ cup olive oil Ingredients in small container and microwave for 2 minutes. Either One skinned chicken cut into 8 pieces OR Then refrigerate to marinate. Any flat fish filets (flounder, tilapia, etc.) Cook pasta and drain. Lots of chopped fresh garlic In a large frying pan add ½ cup white wine and 5 – 6 Bell peppers red/green/ yellow parsley to marinated olive oil mixture and stir. 5 – 6 Celery stalks cut into 1/8 inch slices Add cooked pasta to mixture, stir and serve. 5 – 6 Carrots, sliced into rounds Serves 4. 2 – 3 Onions, diced ½ cup White wine Salt, pepper, Italian seasoning to taste BERNIE’S SALMON WITH GARLIC/ONION Note: Some supermarkets offer time-saving cut- POTATO CRUST up veggies. Ingredients Rice (or peeled cut potatoes placed around 2 lb. filet of salmon edge before baking) 1 tsp. honey 1 tsp. Dijon mustard Directions 1 large potato After vegetables are cut, place into a pot and 1 small onion, chopped saute’ them in a little oil to soften them. 2 cloves garlic, minced In a baking dish with sides place ¾ of veggies salt/pepper to taste and spread them out to cover bottom of pan. Add salt and pepper and Italian seasoning on Directions the veggies. Boil peeled potatoes till soft Add white wine. Saute chopped onions and garlic in olive oil Place chicken (OR FISH) spread out flat on Mash potatoes, then add onions and garlic veggies. Season potatoes with salt and pepper to taste Add remaining veggies on top of chicken or Combine honey and mustard. Brush this fish mixture onto salmon. Add salt, pepper and Italian seasoning on Place salmon in oiled baking pan. top of veggies. Spread potato mixture over top. Bake at 350 degrees for half an hour. Bake at 450 degrees for 5 to 10 minutes Serves 4 to 5. Then, turn on broiler to brown the potatoes Remove from oven when potatoes are Freda and Bernie Samuels of Warrington, PA, stay healthy by eating well and exercising. They are in their late 80s. browned. Serves 4- 6.

SPRING 2014 The Compass - Page 17 NEWS ROUNDUP Use is very high in the Medicaid system, where decent non-drug services may be difficult to Marketing results in overprescription of find. (ConsumerReports.org Dec. 2013) kids’ antipsychotics and other meds. The Psychotherapy’s Image Problem. In an number of children taking powerful antipsychotic op-ed in the NY Times, Brandon A. Gaudiano, drugs has nearly tripled over the last 10 to 15 clinical psychologist at Brown University years. Why? Not because of an epidemic of Medical School, pointed out that the number of serious mental illnesses, but because doctors patients receiving outpatient therapy has fallen are prescribing the drugs to treat behavior sharply, while, at the same time, those receiving problems, particularly ADHD and “disruptive medication alone has increased greatly. behavior disorder,” a use not approved by the Yet, studies show that patients expressed Food and Drug Administration. While prescribed a three-times-greater preference for psycho- mostly for bipolar disorder, depression or therapy over medications. Research reveals that schizophrenia in adults, antipsychotics are evidence-supported psychotherapies (including prescribed most commonly in children to treat cognitive behavioral, mindfulness, interpersonal, disruptive behavior disorder in boys. family, and brief psychodynamic therapies) A disproportionate number of those are the best treatment for patients with the prescriptions are for poor and minority children. most common conditions, like depression and There is minimal evidence that the drugs help kids anxiety. In the short term, these therapies are for approved uses, much less the unapproved about as effective as medications, without the ones, such as behavioral problems. In addition, potential side effects. They can also produce the little research that exists suggests the drugs better long-term results and prevent relapse can cause troubling side effects, including better than medications. weight gain, high cholesterol, and an increased So, why the gap between what people risk of type-2 diabetes, according to a report by prefer and benefit from and what they get? Consumer Reports. Gaudiano feels that his profession needs to Overly aggressive marketing by drug overhaul its image and more aggressively companies and inadequate access to quality promote its empirically-supported methods to mental health care help account for this primary care physicians, insurers, policy makers unhealthy trend. The long-term effects on the and the public. There is no “Big Therapy” to developing brain are not known. counteract “Big Pharma”, with its billions of There is a place for antipsychotic drugs to dollars spent on lobbying, advertising and help manage disabling symptoms caused by research and development. Gaudiano points out severe mental illness or developmental disorder. that some of psychotherapies’ problems come But, for many kids taking the drugs, the benefits from the profession itself as many therapists probably don’t outweigh the risks. fail to recognize and use evidence-based Antipsychotics have become huge psychotherapies. (NY Times Op-Ed, 9-30-13.) moneymakers for the drug industry. In Nov., Shocking lack of good psychotherapy. 2013, Janssen Pharmaceuticals and two other Over the last 30 years, treatments like cognitive- subsidiaries of Johnson and Johnson agreed behavioral therapy, dialectical behavior therapy to pay more than $2 billion to settle Justice and family-based treatment have been proven Dept. claims of deceptive marketing of the to be effective for conditions ranging from antipsychotic Risperdal and other products. anxiety and depression to post-traumatic stress The best approach in treating children disorder and eating disorders. with behavior problems combines nondrug Yet, surprisingly, few patients actually get measures such as parent training and cognitive these kinds of evidence-based treatments when behavior therapy with medication, if necessary. they go for help, said Terry Wilson, professor of Unfortunately, many kids taking antipsychotics psychology at Rutgers University, who urges that have never seen a mental health professional. clinical psychology needs to “commit ourselves Their meds are prescribed by pediatricians. to science.”

Page 18 - The Compass SPRING 2014 Studies have found that too many people with Despite this improvement in mental health mental health problems are getting therapies coverage, many older adults will find that that have little chance of being effective. It seems services are not so readily accessible. This is that the therapists’ biases and past training, because there are not enough mental health rather than research findings on effective providers trained to work with them and because evidence-based treatments, are more likely to Medicare reimbursement rates are quite low. A determine the techniques they use. Though the study published in December, 2013, in JAMA “therapeutic alliance” - the relationship between Psychiatry reported a nearly 20 percent decline in patient and therapist - is important, it must be the number of psychiatrists willing to accept new combined with evidence-based treatment if patients covered by Medicare between 2005 and patients are to be helped, said Wilson. 2010 – with just over half willing to take payment Experts recommend interviewing prospective from Medicare in 2010. (NY Times, 12-27-13) providers before starting therapy in order to find Finally: Proof that men and women are a therapist well-grounded in the latest research. different. A recent study by Raquel Gur, MD, PhD, (NY Times, 3-26-13.) and Ruben Gur, PhD, professors of psychiatry (and Liver damage. All antidepressant drugs husband and wife) at University of Pennsylvania may potentially cause liver injury, even at offers evidence that there is biology behind recommended doses, French researchers report. some of the behavioral differences observed “Antidepressant liver toxicity has been among men and woman. underestimated in the scientific literature,” Using imaging techniques, researchers say Gabriel Perlemuter, MD, PhD, from AP-HP analyzed the conduction of electrochemical Hôpital Bicêtre, Kremlin-Bicêtre, France, and signals, measuring the connectivity within and colleagues. between the hemispheres of the brain. The In some cases, antidepressant-induced differences in “wiring” correlated with differences liver injury can be irreversible. Given that there in behavior. For example, in the cerebellum, men currently is no strategy available to prevent had strong connections between hemispheres, antidepressant-induced liver injury, “early which shows strength in translating perception detection and prompt drug discontinuation to action. remain critical,” they say. (Published online 12- Women had more interconnections across 20-13 in the American Journal of Psychiatry.) the frontal lobes, making them better intuitive WE REMIND readers to get lab tests every thinkers and multi-taskers. The observations 6 months. This is now your responsibility since may not only lead to a better understanding of psychiatrists may forget. the differences between how men and women Medicare will cover more mental health think, but may also provide insight into the costs. For many years, Medicare paid a smaller roots of neurological disorders, which are often share of the bill for therapy from psychiatrists, sex-related, such as autism and schizophrenia. psychologists or clinical social workers than it did The research has sparked some controversy, for medical services. Then, in 2008, Congress with some questioning whether the differences passed the “Medicare Improvements for Patients observed may be the result of environmental and Providers Act,” requiring Medicare to begin influences and education, rather than gender- covering a larger share of the cost of outpatient based genetic differences. (Brain & Behavior mental health services beginning in 2010, with Research Foundation, 12-12-13) additional increases over time. New DSM not all it’s cracked up to be. Just On Jan. 1, 2014, Medicare began paying 80 before the new edition of the so-called bible of percent of the cost of therapy, the same as for mental disorders, the Diagnostic and Statistical most medical services. Parity under Medicare, Manual of Mental Disorders, or DSM-5, was however, remains incomplete since it has a published in Spring, 2013, Thomas R. Insel, lifetime limit on inpatient services at psychiatric MD, director of the National Institute of Mental hospitals, which does not exist for other inpatient Health, said that it suffers from a scientific “lack medical services. of validity.”

SPRING 2014 The Compass - Page 19 The Manual, which categorizes mental the study of developing brain cells. It had been illnesses by symptoms, will continue to be a thought that the adult brain was developmentally necessary tool for clinicians and the basis for frozen – no new brain cells were born. But insurance company reimbursements for some scientists learned that adult mice, rats and time. Unfortunately, said Insel, decades of humans did in fact experience the birth of new spending on neuroscience have taught scientists neurons in certain areas of the brain – one mostly what they do not know. The mechanisms being the hippocampus - an area that controls of the field’s most commonly used drugs - memories and is linked to parts of the brain that antidepressants like Prozac, and antipsychotics regulate emotion. like Zyprexa - have revealed nothing about the Experiments with mice indicated that feeding causes of those disorders. them Prozac had positive effects on behavior Insel’s goal is to reshape the direction of and, at the same time, nerve growth. The birth psychiatric research to focus on biology, genetics of neurons in mice takes about 2-3 weeks – about and neuroscience, so that disorders will be defined the same time it takes for antidepressants to take by their causes, rather than their symptoms. effect. In depressed monkeys, neuron birth in the To that end, he started a federal project two hippocampi is low; when given antidepressants, years ago called Research Domain Criteria in the depressed symptoms abated and neuron order to encourage researchers to disregard birth resumed. the DSM categories and instead, to investigate Perhaps the antidepressants have an effect the biological underpinnings of disorders. He only when new neurons are born. Is this why hopes that researchers will participate in projects Prozac or Zoloft take 2-3 weeks to start working: funded through the Obama administration’s new do we have to wait for the slow rebirth of new brain initiative. (NY Times, 5-7-13) parts of the brain? Helen Mayberg, MD, a Post-Prozac Nation: The future of neuroscientist at Emory University, has gotten antidepressants. Antidepressants have gone remarkable response rates when she stimulates from being “wonder drugs” to being villains. the subcallosal cingulate in the brains of patients Overhyped, overprescribed, and said by some resistant to antidepressant therapy. to be no better than sugar pills, research calls Patients experience an almost immediate and into question how these drugs work. Long powerful change in their moods. The stimulator hypothesized that depression was caused by a can be implanted in patients and works like “chemical imbalance” in the brain, it was thought a depression pacemaker. Interestingly, the that the drugs worked by raising the levels of the response to this electrical stimulation also seems chemical serotonin. to be linked to serotonin, as the nerve cells in the Do serotonin-enhancing antidepressants subcallosal cingulate are sensitive to serotonin. In actually work at all? In the late 1990’s, there was time, insights gained from these researchers will evidence suggesting that antidepressants worked likely lead to new antidepressants: chemicals that no better than a placebo. It was demonstrated directly initiate nerve growth in the hippocampus that pharmaceutical companies had exaggerated or stimulate the subcallosal cingulate. the benefits of antidepressants by selectively Depression is a complex, diverse illness, publishing positive studies while suppressing with different causes and manifestations. There negative ones. Now, however, evidence shows may be multiple sub-types of depression, some that for patients with the most severe forms of of which respond to treatment with serotonin- depression, the benefit of medications over enhancing drugs, and some which do not. And, placebo is substantial, while for those with in some types of depression there may be no moderate or mild depression, it is negligible. In identifiable biological or chemical factors, as in a majority of those who do respond, serotonin depression associated with Parkinson’s disease likely plays an important role. which seems to have little to do with serotonin. Two areas of inquiry by neuroscientists are The latest research suggests that serotonin is, in bringing new ideas and theories to studies of fact, central to the function of mood, although depression and its treatment. The first involves its actions are much more subtle than ever

Page 20 - The Compass SPRING 2014 imagined. Though Prozac, Paxil and Zoloft may “Sleep Therapy” as aid for depression. not turn out to be the “wonder drugs” once Findings from the first in a series of four studies advertised, they have greatly improved the on sleep and depression to be released next understanding of depression and how to treat it. year suggest that curing insomnia in people (NY Times Magazine, 4-22-12) with depression could double their chance of Rethinking Longterm Use of Antipsychotics. a full recovery from depression. If the results For 30 years, psychiatrist Sandra Steingard, continue to hold up, “the advance will be the MD, has treated many psychotic patients who most significant in the treatment of depression hear voices. Until recently, she kept these since the introduction of Prozac in 1987,” and patients on antipsychotic meds indefinitely. should lead to major changes in treatment. The troubling side effects, including tremor and The therapy, cognitive behavior therapy tardive dyskinesia, were the unfortunate price (CBT-I) for insomnia, is cheap, relatively brief the patients paid to keep the voices at bay and and usually effective. The new report from improve their thinking. Ryerson University in Toronto, found that 87% Steingard’s attitude has changed in the past of patients who resolved their insomnia also saw 15 years. First, she became disturbed by the their depression disappear after eight weeks of marketing practices of pharmaceutical companies treatment (either with an antidepressant or a who began to push their medications. The placebo pill) - almost twice the rate of those who benefits, it appeared, were being inflated and could not shake their insomnia. side effects minimized. With one drug, Zyprexa, Doctors have long considered poor sleep it was clear after a year that her patients were a symptom of depression that would clear up gaining weight at alarming rates – 20, 30 even with treatment. They now know that insomnia 100 pounds - in a matter of months. Yet it took can also precede depression. Studies suggest a decade after they were released to the market that developing insomnia doubles a person’s before it was widely acknowledged that severe risk of later becoming depressed. Only recently weight gain and increased risk of diabetes was have doctors begun to investigate the effects common with many of the newer antipsychotics. of treating both the insomnia and the mood Then, two and a half years ago, Steingard read disorder at the same time. Antidepressants, Robert Whitaker’s “Anatomy of an Epidemic,” along with talk therapy, produce a full recovery in which he questioned why, if these new drugs in about 40 percent of patients. Adding insomnia were so great, we were seeing increasing therapy, however, to an antidepressant would numbers of people on disability for psychiatric sharply lift the cure rate, according to results of conditions. Contrary to those earlier studies, recent studies. research now suggests that, over time, people Andrew Krystal, MD, who is running the who remain on these drugs do worse than those CBT-I study at Duke, called sleep “this huge, who stop using them. Those who continued to still unexplored frontier of psychiatry. The body take the drugs were less likely to return to work has complex circadian cycles, and mostly in or develop meaningful relationships. In addition, psychiatry we’ve ignored them,” he said. (NY it appeared that brain shrinkage, previously Times, 11-19-13) thought to be due to the illness itself, was in fact MIT researchers discover possible vaccine caused by the drugs. for PTSD. Researchers at Massachusetts Institute Steingard conversed with her patients, of Technology (MIT) believe they have discovered explaining what she’d learned as well as airing a way to create a vaccine that could prevent conflicting views of other psychiatrists, and to post-traumatic stress disorder (PTSD). They’ve work with those who decided to slowly wean off found that the more stressed one is, the more the their antipsychotics; in some cases, patients had hormone ghrelin is produced by the stomach. been on them for 20 years. She found that her Experiments on rats found that when given a patients make careful and deliberate decisions. drug to increase ghrelin levels, they became It is a choice she now makes with them, not for more fearful, but by blocking the receptors, the them. (The Washington Post, 12-9-13) fear is reduced. Researchers at MIT are now

SPRING 2014 The Compass - Page 21 working on a clinical trial in collaboration with substance abusers, elderly white males, young Massachusetts General Hospital. American Native Americans, residents of the Mireya Nadal-Vicens, MD, of the Center for Southwest, adults who suffered abuse as children Anxiety and Traumatic Stress Disorders at Mass and people who have guns handy. General, works with veterans returning from the Yet, most individuals in every one of those Gulf Wars, many of whom experience PTSD. She groups never have suicidal thoughts – and no hopes that a vaccine can prevent PTSD when data exists to explain the difference between new soldiers are deployed. This treatment would those who will and those who won’t, according also be effective for those suffering from sudden to the cited article below. We have no way of unexpected trauma, like a terrorist attack, or guessing when known risk factors may lead to extended periods of stress, such as child abuse. an attempt. Doctors, including psychologists, The goal is not to change someone’s personality do no better than pure chance at predicting who or erase a bad experience, but to simply prevent will attempt suicide. those traumatic memories from leading to PTSD. Matthew K. Nock, 39, a MacArthur award (FoxNews.com, 12-11-13) winner and director of Harvard University’s Chronic anxiety: A fight for control. Art Laboratory for Clinical and Developmental Carey, whose column, “Well Being” appears in Research, is searching for a way to precisely the Philadelphia Inquirer, interviewed psychiatrist measure suicide risk. His ultimate goal is to be H. Michael Zal, DO, of Norristown about his able to give people a series of tests that could newest book, “Ten Steps to Relieve Anxiety: tell them – and their health care providers – how Refocus, Relax and Enjoy Life.” Zal noted that high their suicide risk is at any given moment. generalized anxiety disorder (GAD), the nation’s Important research in genetics and the complex most common mental health problem, is an workings of the brain will, hopefully, someday inherited biological illness which, though not enable scientists to tailor drug therapies to curable, can be managed so that people can live reduce risk. a good life. Right now Nock’s tests appear to offer the Zal favors talk therapy and a close doctor- best hope for a diagnostic tool that could work patient relationship, as well as exercise, on anyone, no matter what complex social relaxation techniques, medication, and cognitive and biological factors are prompting suicidal behavioral therapy. In his book, he offers thoughts. practical suggestions, including his two chief Nock and his team are currently running two recommendations: avoid avoidance and take tests they developed at military hospitals. The action. Many people with GAD tend to avoid. data will take on meaning over months and years If they take action, they can stop the cycle of as researchers analyze them in light of what the anxiety and feel more in control. (Philadelphia test-takers go on to do in the future: become more Inquirer, 10-20-13) or less depressed, start or stop having suicidal Note: New Directions will sponsor a free, open- thoughts, hurt themselves or attempt suicide. to-the-public talk by Dr. Zal on April 27, 2014 at the And now, a major investment from the Army Willow Grove Giant Supermarket. See our website is set to revolutionize the scope of collecting for details: NewDirectionsSupport.org. data on suicidal behavior. Nock and his team are Predicting Suicide. Despite all the progress participating in the Army Study to Assess Risk made by science, nothing has been able to drive and Resilience in Service members, the most down the suicide rate. Recently, the Centers comprehensive investigation of suicide ever for Disease Control and Prevention announced undertaken. The Army’s access to thousands the suicide rate among middle-aged Americans of volunteers offers a unique laboratory for has climbed nearly 30 percent since 1999. We longitudinal studies. (NY Times Magazine, know there are certain demographic groups “Uncovering the self-destructive impulse that with high suicide rates, including people with a many people hide even from themselves” by mental illness, people who isolate themselves, Kim Tingley, 6-30-13)

Page 22 - The Compass SPRING 2014 BRAIN AND BEHAVIOR it possible for researchers to use 3-D imaging technology to see through an intact, preserved RESEARCH FOUNDATION - brain and into its structures in exquisite detail. News from “The Quarterly”, Deisseroth hopes this technology will help to Summer, 2013 identify brain malfunctions that lead to psychiatric disorders such as schizophrenia, depression The Brain and Behavior Research Foundation and autism. Despite these great technological (BBRF) is a non-profit committed to alleviating the achievements, he still regularly treats psychiatric suffering caused by mental illness. They award patients. This way, he remains aware of “the NARSAD grants to scientists to find causes and level of need, the urgency of our patients’ treatments for mental illness. In over a quarter of conditions..” which he finds a “constant source a century, they have awarded nearly $300 million of motivation and inspiration...and helps guide to more than 3,300 scientists. what I do in the lab.” Every year, New Directions makes a donation to BBRF to honor someone. Past recipients EMERGING NEW TECHNOLOGIES. Stem have included John P. O’Reardon, MD, and Karl cell technology: Zhiping Pang, PhD, on the Rickels, MD. faculty of the Robert Wood Johnson Medical This year, our donation was to Ada Moss School in New Jersey, and others are developing Fleisher, head of our Depression Group and a technology that enables ordinary skin cells to compiler of News Roundup. be genetically reprogrammed to an earlier stage Here is a sampling of news from the work of of development, or transformed into other cell NARSAD Grantees from the Summer, 2013, issue types, including brain cells, for scientific research of “The Quarterly.” and potential therapeutic purposes. In one scenario, patients with a serious illness such as The Brain Initiative. President Obama depression or schizophrenia might donate a few announced a new research initiative - the BRAIN harmless skin cells that would then be induced to Initiative (Brain Research Through Advancing become brain-like cells, which he hopes would Innovative Neurotechnologies)- to “unlock” the have all or at least some of the defects found in mysteries of the brain and map its activity and cells native to that patient’s own brain. functioning, on April 2, 2013. It calls for public This could work like a biopsy works with and private collaboration to support a multi- physical diseases and might provide insights year, broad-based research program to help into brain disease pathology. Another approach researchers find new ways to treat, cure and even would be cell therapy, in which diseased cells prevent brain disorders. Members of the BBRF’s could be replaced with newly manufactured cells Scientific Council and NARSAD Grantees serve made from the reprogrammed skin cells. This on the Advisory Committee. could slow or halt progression of the disease and Research Discoveries in the News. Karl might even have promise in reversing damage. Deisseroth, MD, PhD, of Stanford University, Pang stresses that this promising work is in its a psychiatrist, neuroscientist and bioengineer, early stages. has invented two of the most important new Genetic sequencing. Since the completion methods of learning about brain function. With of the Human Genome Project in April 2003, optogenetics, scientists can switch brain cells researchers have had the unprecedented on and off, one at a time, and then observe the opportunity to study and identify genes and impact on behavior in living animals. This will mutations associated with various mental help them discover how particular brain circuits illnesses. Scientists from around the world work, and what happens when they do not work. have joined consortia allowing analysis of over His latest invention, called “CLARITY,” makes 10,000 samples from people with schizophrenia. rrrrrrrrrrrrrrrrrrrrrrrrrrr

SPRING 2014 The Compass - Page 23 There is a similar effort to study over 2,000 DNA Side Effects of samples for autism. This rapidly advancing genetic work can lead to possibilities for early Antidepressants: The intervention and prevention strategies, as well Neglected Side of as the potential for personalized treatment plans Suffering for individual patients. Rajnish Mago, MD Positron Emisson Tomography (PET). Helen Director, Mood Disorders Program, Thomas Mayberg, MD, pioneered the use of PET scans to Jefferson University, Philadelphia, PA study the neurology of depression, identifying a key locus of depression in the brain (Brodmann Have you ever taken an antidepressant? If so, Area 25). She recently published study results more likely than not, you had one or more side that suggest that specific patterns of brain effects from it. The great majority of patients activity identified in PET scans may help predict who take an antidepressant have one or more which people do better on antidepressant side effects from it. To varying degrees and for medication and which would benefit most from varying periods, side effects bring suffering to cognitive behavioral therapy instead. Other the patients who take these medications. In one researchers have used PET scans to predict study done in Kaiser Permanente clinics, 54% of which antidepressant would work for individual patients on an antidepressant reported having a patients. Thus, though brain imaging is not yet side effect that was very bothersome. The side used to diagnose mental illnesses, it is helping effects of antidepressants usually described as identify abnormalities in brain function linked to being difficult to live with in the long run are a wide range of psychiatric illnesses. weight gain, sexual dysfunction, and fatigue. In addition, the side effects often lead to NEW TREATMENTS. New Psychosis stopping the medication and therefore to poor Treatment: Herbert Meltzer, MD. professor at outcomes of treatment. While there are many Northwestern Medical School, has dedicated reasons why patients stop their antidepressant, 25 years to researching and developing side effects are the most frequent reason pimavanserin, a new medication for the treatment for doing so—much more common than the of psychosis associated with Parkinson’s disease, antidepressant not helping. Latest research has which afflicts almost 60% of those patients. shown that, in the words of C. Everett Koop, the The FDA is expediting approval of the therapy former Surgeon-General, “Medications don’t for which there are currently no approved work in people who don’t take them.” Also, even treatments. Meltzer expects that pimavanserin among patients who are able to bear the side will soon have a big impact in the treatment of all effects and continue the antidepressant, many types of psychosis, especially schizophrenia and patients are not able to take a higher dose due psychotic mood disorders. to the side effects. Exercise for Treatment of Depression. Yet, side effects are surprisingly neglected Specific exercise guidelines for patients with by the medical profession. When clinical trials of major depressive disorder have been developed antidepressants are done, a lot of effort is put by Chad Rethorst, PhD, and Madhukar Trivedi, into showing how effective the medication is. On MD, of the University of Texas Southwestern the other hand, shockingly little effort is put into Medical Center. To deliver the desired identifying side effects of the antidepressant. For antidepressant effect, they suggest 45-60 example, only a small minority of studies use any minutes of aerobic exercise three to five times a specified method to collect information about week at 50-85% of the patient’s maximum heart potential side effects. You will be surprised to rate, plus lower and upper body weight training know that while improvement in depression (three sets of eight repetitions using weights that is assessed by many different ways — several are 80% of the maximum the patient can lift). different questionnaires by the clinician and the

Page 24 - The Compass SPRING 2014 patients — side effects are identified simply that the symptom could be a side effect of the by “spontaneously reported adverse events.” antidepressant, the doctor says it is not a side What that means is that while the patients are effect, or, rarely, the doctor says it is a side effect evaluated in great detail about any benefit that but there is nothing that can be done about it. may have occurred, usually no specific attempt is In one study, 46% of patients with symptoms made to find out if they have had any side effects. thought to be side effects said that they had Also, when patients report that some symptom not discussed those symptoms with either a occurred, there is no strategy used to determine doctor or a pharmacist. When an antidepressant how likely it is that the symptom could be a side is prescribed and the doctor is asked what the effect of the medication. potential side effects of that antidepressant Also, published scientific papers that share are, doctors don’t agree on the answer to that the results of clinical trials of antidepressants question. For this and other reasons, the potential provide only a fraction of the available information side effects often end up being minimized and about side effects. These reports don’t provide many common ones are not mentioned. Also, information about how severe the side effects when a patient reports a side effect, it is common were, how long they persisted, whether patients to ask the patient to wait and watch. For example, who had them were predisposed in some way, even though wait and watch does not work for and so on. But wouldn’t you want to know 90% of patients with sexual dysfunction due to these types of details before deciding which an antidepressant, it is the most commonly used antidepressant to take? strategy. Similarly, when patients see their doctors, So what should be done? Standardized side effects are often not communicated. Find methods need to be developed for identifying that hard to believe? It is now standard medical and assessing side effects in clinical studies. knowledge that in the early years of the use of Similarly, reporting of information about side selective serotonin reuptake inhibitors (SSRIs), they were thought to cause sexual dysfunction effects in scientific papers needs to provide the in less than 5% of patients. Doctors did not details that doctors and their patients need. In ask, patients did not tell. Later, when specific order to help choose the antidepressant, we questionnaires about sexual functioning began also need to identify in genetic tests the genetic to be used, it was realized that about a third variations that will predict which side effects are (or more) of patients had sexual dysfunction more likely to occur in a particular person. I am attributed to the antidepressant. currently conducting a study of this question For many side effects, patients and doctors by using a commercially available genetic test. are not always aware that the symptom is a side Lastly, we need a wave of studies about how effect of the medication. For example, I have seen to prevent, minimize, and treat the different many patients who have excessive sweating as a possible side effects that may be associated result of their antidepressant. I did the first study with use of antidepressants. For example, we are ever done on a treatment for excessive sweating currently conducting a study for the management due to an antidepressant and am now doing a of sexual dysfunction that is a side effect of an second study using a different antidote. antidepressant. At the Mood Disorders Program In all patients with this side effect that I have at Thomas Jefferson University, we are striving seen so far, either the patient does not realize to produce improvement in each of these issues. xxx

SPRING 2014 The Compass - Page 25 Neuromodulation: with the diagnosed condition. This crucial difference allows for an improved response rate A Non-Pharmacologic and less side effects from stimulating regions Approach to the Treatment unassociated with the condition being treated, of Depression as well as decreased systemic side effects. By Lindsay Michel, BS, and The earliest method of brain stimulation is Terrence Boyadjis, MD electroconvulsive therapy (ECT). Introduced in the late 1930s, ECT was proposed as a Generally a chronic, method for generating patient improvement for relapsing illness, major depression based on the notable improvement depression is a costly observed in many with neurological conditions and debilitating disease following a seizure. Currently, the application of of the brain that has a ECT shows greatest benefit in the treatment of direct negative impact severely, acutely depressed individuals with or on one’s physical and emotional health as well as without psychosis and those who have catatonic quality of life. depression as well as schizophrenia and bipolar Depression affects the relationships and disorder. general well being of millions of Americans While the effects of ECT may be rapid and as well as society as a whole through the robust, there are a number of considerations: financial burden of increased healthcare costs high financial cost, the need for general and associated expenses such as lost wages. anesthesia, confusion, and the risk of post- Traditional treatment for depression has involved procedural memory loss. Additionally, the psychotherapy and the use of antidepressant stigma of undergoing ECT has not waned in the medication. However, partial or non-response last 70 years of its use and continues to limit its to the first antidepressant medication is common acceptance. Nonetheless, it does remain an and the likelihood of benefit diminishes with effective treatment option for those who have each successive treatment failure. failed to respond to other treatments. In response, novel treatments for depression Beyond ECT, neuromodulatory treatments have arisen from increased awareness of that have been cleared by the FDA for the implicated neural pathways and anatomic treatment of difficult-to-treat depression regions, technological advancement, and the include vagus nerve stimulation (VNS), cranial generated data from clinical trials. For those electrotherapy stimulation (CES), and transcranial individuals who have been unresponsive to magnetic stimulation (TMS). Approved in 2005 medication or therapy, or for those who have for depression, VNS is a surgical procedure been unable to tolerate medication side effects, implanting a pacemaker-like device under the brain stimulation, or neuromodulation, may be skin with leads to the left vagus nerve. The an option. brain is thus stimulated indirectly from the vagus Neuromodulation is based upon the scientific nerve. Although known to be effective, VNS principle that neurons, the fundamental cells is expensive and invasive with associated risks of the brain, are electrochemical; while drugs from the surgery, as well as post-surgery voice (chemicals) may elicit a response, electrical alteration. stimulation also plays a significant role in Another approved method of influencing brain activity. neuromodulation is cranial electrotherapy Unlike systemic pharmacologic interventions, stimulation (CES)—for example, the Fisher however, electrical stimulation of the brain may Wallace Stimulator. Although approved, this be targeted to the specific region—either cortical device has stirred some concerns by the FDA regions or deeper brain structures—associated as to how effective this treatment might be due ------

Page 26 - The Compass SPRING 2014 to its intended use by the patient him or herself Neuromodulation Offers rather than in a medical setting. Currently, there is not enough peer-reviewed data to support the Hope for Unremitting safety and efficacy of CES. Depression Experimental therapies that are not FDA- by Ian A. Cook, MD, of UCLA approved but are currently under investigation are magnetic seizure therapy, synchronized Note: Ian A. Cook, MD DFAPA, transcranial magnetic stimulation (sTMS), is Director, UCLA Depression transcranial direct current stimulation (tDCS), and Research & Clinic Program; Chief, deep brain stimulation (DBS). While DBS has UCLA TMS Treatment Service; been approved for the treatment of Parkinson’s Professor of Psychiatry and Bioengineering, Disease since 2002, it is still under investigational David Geffen School of Medicine at UCLA Semel status for the treatment of depression. It is our Institute for Neuroscience and Human Behavior hope that further research of these emerging at UCLA, Los Angeles, CA technologies may one day provide available Dr. Cook emailed us a recently published treatment options for depression. article he and colleagues at UCLA wrote about In summary, neuromodulation is a safe and “neuromodulation” approaches to serious mood proven treatment option whose roots date back disorders. 70 years. This exciting and evolving technology Here’s what he wrote: shows much promise for the treatment of Instead of using molecules to influence the brain depression. Because of its safety, efficacy, and thus mood, neuromodulation approaches use tolerability, and the ease of delivery, transcranial energy (electric or magnetic fields) to affect the magnetic stimulation, or TMS, has now become brain and achieve therapeutic goals. the most widely used method of brain stimulation In it, we discuss an FDA-approved approach in the outpatient psychiatrist’s office and is (transcranial magnetic stimulation (TMS) that increasingly being utilized world-wide. is available now, and two approaches that are TMS is a non-surgical, non-invasive treatment under development -- one that involves brain which does not require anesthesia or medication surgery (deep brain stimulation or DBS) and one and has no associated cognitive side effects. A that is completely non-invasive (trigeminal nerve full course of therapy for the treatment of acute stimulation or TNS). depression is comprised of daily sessions (M- TNS is available now outside the US, and F), each lasting approximately 40 minutes for a is the focus of research activities in the US at period of four to six weeks. For these reasons, present. (In the interest of transparency and experts in the area of brain stimulation expect disclosure, please bear in mind that I am one of that TMS will be the preeminent means of the inventors of TNS and I advise the company neuromodulation in the future. that is developing it, www.NeuroSigma.com. Terrence Boyadjis, MD, is in private psychiatric practice in One of the companies that makes TMS West Chester, PA. He treats adolescents and adults. He is devices, Neuronetics, Inc., happens to be also the director of the TMS Institute of Pennsylvania, and, headquartered in Malvern, PA. You may be able with Lindsay Michel, the clinical coordinator, provides TMS to ask one of their staff to give a talk about TMS, Therapy. if that is of interest to the New Directions group. [New Directions has previously hosted Terrence Boyadjis, MD, of West Chester, PA, and John P. O’Reardon of the University of Medicine and Dentistry of New Jersey.) I hope the information in the article will be of interest to you and the readers of your Compass magazine. 8 Best wishes.

SPRING 2014 The Compass - Page 27 The Compass has condensed the first few CATCHING UP pages of his article published in Neurosurg Clinic N Am (2014) by Cook and his colleagues. Read Vince of Doylestown, PA, writes that after the entire article online. he was diagnosed with bipolar 2 “my life was out Key Points: of control. I lost two jobs and was on the verge • Despite best practices for the management of losing my family.” Overmedicated, he’d had of MDD with medications and psycho- multiple hospitalizations and “was not feeling therapy, many patients do not fully recover anything like myself.” His wife found him a new and need other treatment options. psychiatrist who finally got him stabilized. Still, • Neuromodulation interventions span from he was not feeling like himself. surgically implanted devices to noninvasive His doctor suggested he read the book systems. “Wherever You Go, There You Are,” by Jon • Neuromodulation interventions may have Kabat-Zinn. The book presents basic meditation complementary mechanisms of action, and techniques as a way of reducing stress and may offer new hope for recovery for patients healing from illness. with pharmacoresistant depression. He began meditating every day in the morning • Additional comparative research is needed before doing anything else. With his doctor’s to clarify how best to make use of these help, he began cutting back on his meds. In 6 technologies. months he was completely off all meds and has Major depressive disorder (MDD) is a been med-free for two and a half years. common, disabling and undertreated condition. Other factors are at work in his healing. “I With a lifetime prevalence of 1 in 6 and an annual have a strong support system at home and I’m prevalence of 6.6%, at least 20 million Americans back to work in my field of education. I feel will have an episode in 2013. In middle- and high- confident my wellbeing is for real as I have had income countries, MDD ranks above ischemic to deal with many stressful issues, which I have heart disease as causing annually the greatest been able to take in stride.” Meditation, he says, disability for both men and women. trained his mind to think differently. It has been estimated that 40% of North Judy Kroll of Holland, PA. I take a Women’s Americans with MDD do not receive any ski clinic at Bear Creek Mountain in Macungie, treatment. PA on Thursdays. For those who do receive treatment, the I started taking skiing lessons around 6 years landmark STAR*D study (Sequenced Treatment ago because I suffered from seasonal affective Alternatives to Relieve Depression) found that disorder (SAD). So I decided that rather than less than one-third of adults with MDD remitted spend 4 months of the year in abject misery, I with their first medication trial and, thus, a majority would give this a try. Originally I began at Spring need to try something else to aid recovery. The Mountain and was taught by 75-year-old women. likelihood of achieving remission decreases with They were very inspirational! each successive pharmacologic treatment, while Being outside and having the sun shine on the 12-month rate of relapse increases 71% after my face, coupled with being physically active, 3 failures). really helped my mood. The women in both There clearly is a need for treatments that groups were all very supportive. I even bought have both greater efficacy and durability of my own skis and boots!!!! benefit. The clinic I’m in today focuses on women’s issues like fear and confidence and talks about centering strategies as well as skiing techniques. The hobby is a Godsend and helps me to have something to look forward to in the winter months. I don’t know how I ever made it through iii winter without it. It’s exhilarating! Rob Lokoff of Conshohocken, PA. In January,

Page 28 - The Compass SPRING 2014 I watched a 76ers game with my son Jacob at the active, or obsessive about something, I should Wells Fargo Center. The Sixers lost by 31 points stop for a half-hour or more. If I feel I can’t force (which is a lot) but we had a good time anyway. myself to take a break for this short period of After the game we drove deep into South Philly time, I may already be in or on my way to a and got a real Philly cheesesteak at the world- hypomanic state. famous Genos. Anyone visiting Philadelphia has (3) If and when I realize I am having trouble to make a stop at Pat’s (The King of Steaks) or refraining from my “obsession” or activity, I Genos. should talk to my doctor about slightly adjusting Dave fought depression for years, trying my meds until the hypomanic state has passed. all sorts of meds. Last year he began a series (4) I am not allowed to adjust my meds of electroshock therapy (ECT) under Dr. John without my doctor’s permission, but with his/her Worthington at Abington hospital. He had a approval and my detective work, I can manage series of 12 treatments, three times a week, and my mood more effectively. is now having “boosters.” It starts out once a week, then goes to every other week, then every DEAR LITHIUM, third week. ECT seems to be doing the trick. He’s now able to get out of bed and do electrical It is with much consideration and a voice work in his own home in Bucks County. He has from my all-knowing gut that I have arrived at the stopped isolating himself and enjoys attending decision to break up with you. I still care for you family gatherings with his large loving family. and will be forever grateful for the things you Jonatha A. Johnson of Vicksburg, Michigan have done and showed me. When I was at my writes: Just bought a ceramic- lined skillet with darkest and most undefined moments you were glass lid made by CookingPleasures for $10. I there for me, without question or hesitation. got this one in a special deal in the mail, as a I am afraid to admit what would have promotion. It’s lightweight, for folks with arthritis. happened to me in those dark moments without Today I inaugurated it, but first I read the you. When my senses were broken, you provided rules: No high temperatures. Don’t store salty a cast to hold them together. You were a light foods in skillet. Never heat an empty skillet. So, bulb. During our time together, my senses healed. I cooked up some thin-sliced sweet potato, with With that light bulb, I was able to gather sticks slivers of onion, a drizzle of olive oil, a pat of and create a spark to start my fire. It’s not that butter, and let it slowly steam-fry on low temp. your light bulb wasn’t much appreciated – it was! Splash of lemon juice to enliven the works. - but here’s the thing…I am not lost anymore. I Denis Hazam, who runs a mood disorders want more, I need more, I deserve more. group in Philadelphia, says he has a long work The truth is that when you met me I wasn’t history and was an entrepreneur as a kid. He was myself. I was Hailey James, the creative- a paper boy at age 9 in his apartment in NYC. In determined hot shot. Shortly before I met you I the summer, he’d stay with his grandmother at got trapped in a horrific storm that knocked out Point Pleasant, NJ, where he would dig up clams, my instruments and destroyed my senses. The put them in his little red wagon, and sell them things that I never thought I would ever lose to neighbors. Today, he and his wife Fran work about myself were taken from me so quickly at the Mental Health Association in downtown and effortlessly. I was left with nothing, just the Philly. darkness. Tiffany of Dresher, PA, writes: I learned these Now my life is full of light and self-confidence. lessons from Randy, a certified peer specialist at But, as my mind was healing, my body was a New Directions meeting. I am not at the mercy rotting. When we were together, I easily got of my moods! Sometimes I have the ability to colds, which turned into severe flus, headaches prevent or avoid manic episodes! that turned into debilitating migraines, not to (1) Pay attention to my body for early signs of mention the fainting, the hospitalization due to (hypo)mania. toxicity, and medically undetermined seizures. (2) If I feel I’m starting to be overly energetic, I know it won’t be easy separating. I hope to

SPRING 2014 The Compass - Page 29 never fall into that inescapable darkness again, around your neighborhood.” but if I do, I know you will still be there. As we When she called me that night, I told her that part, please remember, there is a love for the not only did I go for a walk, but I went to my gym past, awareness for the present and hope for the and exercised. future. I’m a new woman and I understand what it is It is time for my body to heal, just as my mind like to be depressed. I’m motivated now to look has healed and continues to push the envelope for a job. My husband is very supportive. forward. In China, people are very secretive about With much gratitude and a bittersweet mental illness. I just mailed my sister an 88-page goodbye, photo book from her trip here. Hailey James Compiling the photos was time-consuming, but I couldn’t stop. I think it was the way for me to release my love, sadness, and missing them DEPRESSION HURTS since they went back to China. by Ling from North Wales, PA. It was tough for me, a strong woman, I believe. My sister and her 10-year-old son visited me Somehow, I feel guilty that I had no power to from China, where I was born and grew up. It was keep them here in the States. They wanted to wonderful to see the two of them. I hadn’t visited live here. in five years because I was busy running a coffee I have even stronger feelings and sympathy shop that I closed down. for her now after I suffered my depression. One Then I attended Temple University and got a day her husband went to work and he never degree in business. returned home, never said a final goodbye to his In China, my sister Lee had a terrible shock, wife and young son. How painful it was for her. something she was totally unprepared for. Her It is like magic how people change their mood beloved husband fell off a ladder and died. because of environmental changes surrounding The family never told the little boy, Qiang, them, and it is so powerful beyond personal age 4, about the real circumstances, only that his control. In China, people are not allowed father went to heaven. freedom of religion, speech, and press. During We did many fun things during the time she the Cultural Revolution, people were killed stayed with my husband and me. We flew out because of telling the truth. People are nice, but to California, where I first lived when I came to they need to survive. So, they had to change America, and we saw Disneyland and Las Vegas. to fit the environment, as in Darwin’s theory of My nephew Quiang enrolled in school here in evolution. North Wales – he was in the fifth grade - but had Some people turn to practice “qigong” a tough time because he doesn’t speak English. (healing and energy techniques), while others go Two weeks ago they left. to fortune tellers when they encounter difficult Suddenly the house was quiet. I missed the times. My sister visited somebody who can vibrancy of my little nephew. predict the future, at least, she believes so. My He was curious about everything. And my thinking is that they are similar to psychologists sister was very chatty. Now, I have no one to talk here. These fortune tellers are special people. to since my husband is at work all day. They have some knowledge ordinary people I have never been depressed before in my don’t have. life. I could not get out of bed. I could not get out People need faith or hope to lighten up their of the house. I felt hopeless. I finally understood life. In China, many people believe that their what “depression” is all about. ancestors are watching over them. They visit their I called my friend Ruth. graves to be with them and to ask their blessing. “I’m going to give you an assignment,” she Since my depression, I wonder about the said. “After we hang up, go for a half-hour walk meaning of life sometimes.

Page 30 - The Compass SPRING 2014 The PTSD Experience: “We have nearly completed a new song Three Stories about PTSD and will introduce it at the show.” Here in the Philadelphia area, Edna Foa, From the Introduction PhD, of the University of Pennsylvania, has had After returning home from two years in Iraq, success in treating posttraumatic stress disorder I began writing a novel exploring the events (PTSD). Contact her department at http://www. of my life before I left. That puzzled my sister, med.upenn.edu/ctsa/ a reporter. If you want to write a good story, Seeking to interview a veteran from Iraq or she said, explain why a 54-year-old guy would Afghanistan, I spoke with PA State Rep. Thomas quit his job, sell his house, leave everybody and Murt (R-152 nd legislative district in Pennsylvania). everything, and go to Iraq. There is a market for Murt served in the US Army Reserve and was that, she promised. To understand, I answered, called to active duty in 2003. He served in Iraq you have to examine what happened back then. for a 14-month deployment. She thinks she knows why I went. Some days I He told me, “Veterans do not want to be understand, but only some days. That’s why I interviewed. They are stigmatized for their PTSD write, to figure things out. and there’s a lot of it when they come back from Iraq or Afghanistan. If it’s known they have PTSD, Camp Victory 22 June 2005 they’re not given choice assignments.” Email to my brother. Last year, I interviewed two veterans from Iraq and Afghanistan. Justin Stone and Derrick Bro, Lilley found that working in construction was the Lots of booms today. There was a whopper best way to get back to their normal lives. Both in the afternoon. I don’t know what it was, married with children, they credited their wives probably a car bomb. After supper there was with being their best supports. The article was a rocket barrage, seven I think. They landed in published in the Upper Moreland Patch.com. a living area and wounded at least four soldiers that I know of. AN AMERICAN IN IRAQ After supper, I was going to go for a walk. I by Phil Nerges decided to take a shower before I left. While I was taking the shower, the rockets started coming in. Note: Phil Nerges, from New I didn’t hear them in the shower. When I came Jersey, worked as a contractor in out everybody was running around. Someone Iraq in 2005 and 2006. Below are told me what had happened. Three had hit excerpts from his “Iraq Journal: about a block away. I took a walk up to look at Sketches from the Contracting the damage. While I stood there, I overheard a Life,” 2011. soldier making a report by cell phone describing “I compiled my notes and the casualties. There were four at that spot. I emails and put them into this book,” said would have been very close to where they Nerges. “I also wrote a book of short stories and landed if I didn’t take the shower. I made the wrote songs for each story. Vic Ruggiero of the right choice. It would have scared the piss out band The Slackers put the lyrics to music, then of me to be close when they hit. I don’t know recorded them. (See YouTube “Phil Nerges.”) about casualties in the rest of the camp. “We have constructed a musical from them They weren’t the big rockets judging by the and perform the show once or twice a year in damage, lots of shrapnel though. I could see the Manhattan or Brooklyn. A theater company has shrapnel pattern on the stucco wall. Scary stuff. now joined us, performing sketches from my It’s late. I’m going home now. stories between the songs. As far as I know, it’s Camp Scania. 20 November 2006. A story the only musical about contractors in Iraq. The is circulating about the driver who lost his arms. next show is April 24, 2014 at Desmond’s in After the grenade exploded, he managed Manhattan. to drive his rig out of the kill zone. It’s hard to

SPRING 2014 The Compass - Page 31 comprehend how anyone could do that, so badly I tried to sleep through it, but they just kept injured. barking. I got up at 0530 hours and looked I’m having more and more trouble controlling outside. I heard the call to prayer coming from my moods. My most faithful companions are the village and I wondered if shooting was about anger and depression. I think of the ride up to start. The insurgents like to fight after praying. yesterday, how pissed-off I was at the commander I marveled at the stars, so beautiful. I thought of who excluded us from his convoy. I thought it the other night too, of lying in the mud. as a petty display of authority. But then, they 11 December. The truck drivers smile when spotted the IED. His choice put us further back, they reach camp because they’ve reached safe into the second convoy, where we were less likely haven. Inside the camp, the mortars might go to catch an IED. Now he seems like a genius. off blocks away, but out on the road, the bombs Every time a door slams or something falls go off right next to them. Mortars barely interest over, I jump. I’m always ready, awake or sleeping, the drivers because there are bunkers to hide in. to dive on the floor. Sometimes I feel silly about They have no such luxury out on the road. No that, but I can’t control it. I hurry when showering worries about RPGs (rocket-propelled grenades), fearing an attack. I sleep partially dressed so shaped charges, or ambushes inside the camp, I’m ready to run out the door during the night. plus we have hot food and showers. What more Some people take the attacks matter-of-factly, could anyone ask for? as though they’re confident nothing will happen Their perspective is refreshing. They make to them. Others think, why worry? Inshallah everything sound so rosy. (“if Allah wills”). When I think of danger as an 2 December. Another wonderful day abstract statistical number, it’s not very scary, but helping my Iraqi brothers taste the sweet fruits mortars are tangible, and I’m out of here at the of democracy. I learn a few Arabic words each end of this contract. day and they laugh at the way I murder their language. They remember my name because it 9 December 2006 . Email to my brother: means something like beautiful daffodil in Arabic, I can’t shower without thinking about feminine, a comical name for a man. A truck full shrapnel tearing through the walls to rip my dick of Iraqis passed the other morning as I walked off. I shower fast. Maybe I’ll take a direct hit and along the road. Hey Nerges! Hey Nerges! They the last piece of my smoking carcass will tumble laughed. to the ground at somebody’s feet. They’ll stand there, bewildered, watching the steam rise from After the last mortar attack, I asked our Iraqi my intestines, pondering the terrific stink. workers if they were the ones mortaring our When things are touchy, I sleep in my clothes. camp at night. They laughed, entertained by the I can go from deep sleep to a full run in the blink suggestion, but didn’t say no either. I guess you of an eye. Some nights I fumble, other nights I’m need a sense of humor here. blazing fast. Phil Nerges worked as a contractor in Iraq for two years I imagine my dying thoughts, of Beth, (my ex- between 2004 and 2006. He is a lifelong New Jersey lady friend) I can even hear her words: I knew resident, and resides in Toms River with his wife Donna. His it! I knew it! I told him not to go there. He had short stories have appeared in Amoskeag, The Journal of Southern New Hampshire University, Foliate Oak Literary a choice, the money or me, and that bastard Magazine. His collection of short stories titled They Must picked the money. be Hungry appeared in Spring 2011. He collaborated with 10 December. Dogs barking in the village musician/songwriter Vic Ruggiero to create a story/album next to the camp woke me off and on all night. collection about Iraq titled “Tampa Road.” ooo

Page 32 - The Compass SPRING 2014 I Married Trouble sets it off again. By Jill I have flashbacks sometimes when I’m awake, New Directions too. I never know what may send me into a spiral. It’s a life of uncertainty. I will never feel I was married to a police officer who abused me. For most of our 15-year marriage, he mentally truly safe. I always have my guard up. I am very abused me, belittled me, controlled me and took insecure. I have so many fears. Some days are away every ounce of my self-confidence. During good days but some days are unbearable. I have the last four years of our marriage, he became trouble concentrating, my thoughts will wander. worse. He would beat and torture me on a daily I feel I will never be totally all right. I think I will basis. always be different and never fit in with “normal” I was mentally, physically, psychologically and society. I feel broken. sexually abused. He wouldn’t let me leave him. I know I’m a survivor, no longer a victim, but He took drastic measures to keep me at home, living with what he did to me is embedded so nothing was off limits in his quest to control me deep inside me and something I will probably and not let me leave. Violence, threats, abuse, have to deal with for the rest of my life. The torture, stalking. Anything! bottom line is I am still here and my life will go He involved other cops to keep me a prisoner on. in my own home in the Greater Philadelphia area. I am very fortunate to have such a supportive Nobody could or would help me. If he couldn’t family. They have really helped me get through have me, no one could. Leaving him was not an option I had. In my mind, it wasn’t a question of many hard times. I am so lucky to have survived If he was going to kill me but when. He made it to be able to watch my children grow and have clear my life was in his hands and he could make their own children. I survived for my kids. I have me disappear anytime he wanted and nobody a wonderful fiance who has helped give me would ever find my body. strength when I felt I had none. I am so grateful He pointed a gun at me every day. During he is a part of my life. I volunteer at a woman’s the abuse I was able to disassociate myself at center to help other abuse victims and also times. I lived in constant fear. I felt so helpless volunteer at a no-kill cat shelter. and isolated. When I finally did get a protection Note: Jill has been in therapy since the from abuse order, he broke into the house and shooting. She has had EMDR therapy (eye shot me in my chest. Then he shot and killed movements that are supposed to re-program himself. That was on Jan. 12, 1999. I bear the the brain) and cognitive behavior therapy. She physical scars from all the abuse I endured; but, currently sees a therapist who specializes in it’s the mental scars that are the most painful and trauma once a week. She takes medication: still haunt me to this day. antianxiety, antidepressants plus sleep meds. I suffer from post-traumatic stress disorder (PTSD). I have horrific nightmares to this day She also takes an alpha blocker “prazosin” that about the abuse. I go through periods of time has positive effects for soldiers with PTSD coming when I suffer horrible panic attacks and racing home from the wars. heartbeat in my sleep and when I wake up in the She attends depression support groups and morning. Sometimes I’m afraid to go to sleep. became very involved in women’s abuse groups. I go to some very dark places in my mind. I will Best of all, she began working part-time on a get it under control for a while until something farm, helping with the animals.

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SPRING 2014 The Compass - Page 33 IN THE REARVIEW MIRROR & and who had been, for the past couple of years or so, on a rapid, progressive downhill course of THE MIRROR OF NOW: the disease. My Personal Tale of Loss and At that point, he was without use of his legs Trauma and one arm. Along with the physical symptoms, Note: This article is slightly there was evidence of brain plaques as well, condensed from the original, affecting his emotional state, though not his which you can read in cognitive ability. He had not been able to its entirety on Iris’s blog work at his social work job in child welfare for VisionPoweredCoaching. some time, or to continue with his plan to get com. a graduate degree to become a psychologist. by Iris Arenson-Fuller That morning, I wanted to get the clothes dried so we could get him ready for the day, because “Ordinary” used to be synonymous with we had clients coming for an appointment at “boring,” as far as I was concerned. I didn’t the adoption agency Kim and I had founded six much care for the commonplace or routine. I months earlier. The agency office of “Thursday’s preferred excitement and change, but that was Child” was in our home. mostly when I was a lot younger. Now, though I hadn’t been in our downstairs bedroom I still tend to get bored easily, I prefer to have a for more than a minute or two, busily arranging generous amount of calmness and predictability the wash basin and other needed things, when in my life. I will tell you a little about why. I heard an odd pop that sounded like it was March 12, 1982 felt like an ordinary day when it coming from several rooms away. I poked my began. Most days seem ordinary, I think, except head out of the bedroom door and peered in retrospect, when we already know what has around the corner in the direction of the kitchen. befallen us, whether simple or complicated. The This was the precise moment that our lives began rear view mirror is usually frighteningly clear. The to change forever. I saw flames shooting out of crystal ball, if we have one, tends to be murky the kitchen. Operating on adrenaline, without and ambiguous, thankfully, or most of us would having time to think, I shouted out reassurances not survive what we saw ahead of us. to my husband that I would be right back to get I was a bit tired that day and had gotten off him, and ran into the front room to get our son, to a slow start. With a neighbor, I had taken our Ben, out of the house. I don’t recall the words preschoolers to see a performance of Sesame I used with Ben, but I was very stern. I let him Street Live the night before. My young teenaged know he was to leave the house, go directly son and his pre-teen sister were left in charge next door to our neighbor’s home, that I would of helping their disabled father for a few hours. call the local fire department, and would get his We didn’t know that evening would be the last father out. I am frankly not certain when I called time they would see their dad alive. They left for the Fire Department, or even if I did. Some of school the following morning, while he was still what happens is quite blurry in my memory. I asleep. suppose it is a self-protective device. Yet certain There was a load of clothes in the dryer. My images and feelings are more clear and vivid husband was patiently waiting for me to help with than I would wish them to be. his morning routine, which involved a bed bath, I remember shoving Ben out the front door dressing, getting him out of bed with a Hoyer lift, on the opposite side of the house from the fire, and into his wheelchair. Our four-year-old was telling him not to return under any circumstances, in the front sitting room, happily mesmerized by and rushing back to the bedroom to get Kim a Sesame Street episode. Our older kids were out of the bed. Normally this was an involved already well into their day at school. I was in process, but again, I wasn’t thinking clearly. I the bathroom, gathering up the supplies I would remember lowering the hospital bed, trying to need to wash and dress my young husband, my detach his urine bag that was on a tube wound college sweetheart, who had Multiple Sclerosis around the bed railing. I recall trying to stay calm

Page 34 - The Compass SPRING 2014 and reassuring him that help was on the way. The drive me to the hospital, but they said I had to room then went completely black and filled with wait just a little while. smoke. Only a short time later, a policeman arrived to I heard a voice at that moment. It was distinct, tell me Kim hadn’t made it. The policeman went strong, and maybe in my head, or maybe not. I to the kids’ schools to get our son and daughter. will never know. The voice told me that if I didn’t I don’t think they told them the truth on picking get out immediately, my kids would all become them up, but just that there was an emergency at orphans, and that I wasn’t going to be able to home. The ER doctor soon called and confirmed move Kim all by myself. Though it is nearly 32 that Kim had died quickly of smoke inhalation and years later, as I write this, the tears are already though he had heat burns, he had not been alert streaming down my face. I knew it wouldn’t be and had passed out rapidly. The doctor said that easy to write about, even though I have done Kim’s lung capacity was already compromised it before a little bit, and have discussed it with due to his condition, and to chronic asthma, so it others, including therapists, over the years. hadn’t taken long for him to black out. I stood outside screaming, for what seemed I won’t go into the details of the next year, like forever, though it was most likely about except to say that we moved from friend to three minutes since we lived right between friend till we located a temporary rental home, two fire stations, each less than a mile away. To and till I decided what to do. Our house was trick my mind and to begin my arduous journey badly damaged but had not burned down. Most of survival, while screaming, I also talked to of our belongings were destroyed. We had no myself and concocted a story in my head that life insurance, but the homeowner’s insurance Kim would be fine, but that our Scottie dog, would cover the repairs on our house if I chose Charlotte – I had forgotten about her in all of to do that. We were out of our home for about the chaos - would be gone. I told myself that I a year. My mother and sister were three hours would need to work very hard to keep Kim from away and still reeling, as was I, from the fairly getting horribly upset over her death, and from recent death of my father, the sudden death of going into a new acute exacerbation episode of my young nephew only four months before, as his disease. well as my brother’s death. The firemen arrived and started breaking My mother did her best to help and stayed down doors and windows. A neighbor from with us for a month after we moved into the across the street arrived, and a fireman instructed rental house. I had so many things to take care her to take me down to the bottom of the lawn. I of and was hardly in the shape to do it, but I didn’t want to go. I was told later that I was pretty did. That included going back into our severely hysterical, but don’t remember. They carried Kim damaged home and conducting a property out on a stretcher and put him in an ambulance. inventory so that we could recover some money Then in a move I am sure they thought was the on the property coverage. I insisted on doing it right thing to do, but for which I honestly wasn’t alone, though my mother offered to accompany able to forgive them for years and years, they me. Being in the house alone was torture, but it barred me from getting into the ambulance. was something I needed to face before I could They motioned for the driver to be on his way. move on. Kim was still alive. I quickly got us into family therapy because Suddenly someone put our little dog into it seemed like the right thing to do, but my my arms, and she was okay. Another neighbor worries, my anxiety, my growing rage, and what took me and the dog to his house. He had given I was later to learn were PTSD symptoms, began the phone number to the police and ambulance to plague me. I suffered for a long time from driver. My next door neighbor brought little Ben survivor’s guilt, and it didn’t help that most of to me, at my insistence. I begged everyone to my in-laws seemed to blame me, too, and would qqqqqqqqqqqqqqqqqqqq

SPRING 2014 The Compass - Page 35 have little or nothing to do with me. I found a without warning, I would have a sense that the therapist for myself and over the years, switched car was going to catch fire and/or explode. I to a few different ones, being dissatisfied with would briefly see the flash of flames that I saw my progress, or with their methods. When the that horrible day of March 12, 1982. I would older kids didn’t wish to continue with therapy, need to calm myself as much as possible to I decided that the gift I had to give them was to resist wanting to jump out of the vehicle. continue myself, so that I would not fall apart. I then started to have panic attacks and As soon as the shock and numbness of what flashbacks while in the shower. I would suddenly happened wore off a bit, I started having terrible hear the smoke alarms going off, and an nightmares, reliving the events of that March (imaginary) voice screaming the word “fire” and day. The nightmares weren’t only when I slept, yelling at me to get out. I would run out of the though. Unexpected triggers would set me off. shower, dripping wet, open the bathroom door, I would suddenly have vivid images flash before stick my head out and listen, sometimes having me. They seemed too real to be in my mind. to do this several times during one shower. I My body would shake and I would sometimes began to practice visualizing some peaceful vomit. Certain smells and sounds would set me scenes and repeating positive affirmations off too. When a fire truck zoomed by with sirens about my safety, and my ability to stay in control blaring, I would shake and feel nauseated. of myself. That helped. I still use those tools a Sometimes I would actually vomit. If I passed lot, having perfected them so they work better a burning leaf pile, or walked the dog at night and better. when a neighbor’s woodstove was burning, I After switching therapists several times, would be transported back in time and would trying different modalities, I settled upon one often lose control. person who really seemed to “get me”. She At night when awakened, I would scream didn’t want to go back into my past and waste and it would take me a while to realize where a lot of time on things I had already worked on I was. I was afraid to go to sleep. I kept losing for years, and felt I had a pretty good grasp of. weight and started to develop other physical She helped me with some very practical tools problems. In spite of my best efforts, and my for relaxation, some guided imagery skills, and therapy, as well as knowing better, I sometimes she recommended that I see someone trained overreacted with my kids, and particularly with in EMDR techniques. the older two. Mostly my symptoms besieged EMDR stands for Eye Movement me when I was quiet and alone, but at times Desensitization and Reprocessing. It is, they happened when I was in a store or in some simplified, a way of retraining the brain, and other public place. providing people with the tools and skills to I kept it together professionally, continuing handle the triggers and situations that set to direct our licensed adoption agency, but I them off. It has been used successfully by was always fearful that something would trigger the U.S. Veteran’s Administration and private one of my episodes. I was unable to watch practitioners to help people who suffer from movies or TV programs that had fires. Although serious emotional distress due to traumatic I avoided these shows, occasionally scenes experiences. I believe the EMDR helped me came up without warning. I learned to leave the somewhat, but was, sadly, not any kind of a room, but it usually took me a long time to quiet magic cure. myself. Little by little, after many years, and practicing I also began to have episodes and flashbacks a combination of self-help and professionally while driving, but I had to drive. I was a mom of recommended techniques, I began to have three kids (I later adopted a fourth child on my fewer and fewer episodes. I know I was/am own when in my forties), ran a business and a one of the lucky ones, since some are severely household. This only seemed to happen when plagued by their PTSD and trauma-related I was by myself in the car. I would be driving symptoms forever. I knew, though, that I had a along, feeling perfectly calm and suddenly, lot of years ahead of me, a family to raise, a life

Page 36 - The Compass SPRING 2014 to live and talents I didn’t want to go to waste. bearable challenge. We are all made differently In spite of my past pain, I set an intention and have unique responses to life. Everyone at to get past this, to find better ways to handle some point will suffer loss, whether it be of a my loss and trauma issues. I suppose I had loved one, or of something important to them. reached the place I often observe in coaching Some people are able to pick themselves up and my clients when they are completely fed up with start over. That doesn’t mean they don’t hurt, or their own suffering, and are finally determined to aren’t grieving, but that they have found ways to do something about it. I don’t in any way judge cope. Others are truly traumatized, need help to those who can’t do this, because I relate to how move on and be productive and positive once strongly these disorders can affect people. I do again. There is no reason to continue to suffer, think there is help out there and one must not and to feel it has to be handled on our own. Also just accept suffering. the intense pain can be shortened with the right I rarely have nightmares now. I can take a approach and assistance. There is a lot of help shower without feeling there might be a fire out there and it’s important not to be ashamed in progress. I don’t have episodes in the car or embarrassed to seek it. anymore. I continue to have a very hard time I imagine I will always suffer to some extent watching TV programs or movies with fire scenes. from some of the symptoms I have experienced. I have worked on my grief too, and that is I am not cured. Nor am I cured of grief and ultra-important. I have allowed myself to feel it. of missing those who are no longer with me. In the early stages, I hurt a lot, more than I can Endings are part of life, and there are always new ever describe, but was too busy tending to what beginnings, if we are willing to see and embrace had to be done for everybody else, and to putting them. We can be more than just survivors. We our physical lives back together. I recognize and can be strong survivors! finally was able to understand that I had what is Iris Arenson-Fuller, Certified Professional Coach, ACC, is a called “complicated grief.” This is a long-lasting Life Stage, Family, Relationship Changes Coach, expert at and intense form of grief that tends to seize helping people through tough life changes and loss, as well control of one’s life and keep people stuck. as adoption issues. She is also a poet/writer. Learn more at VisionPoweredCoaching.com., ExpertAdoptionCoach. This grief, because of having lost so many com and her blog CoachIrisBlogs.com. She lives in dear to me, both family members and close Bloomfield, CT. friends, and because of the multiple stress factors involved, needed to be confronted on different BAD DISEASES HAPPEN TO levels. I learned to use the creativity I had always had to help me find ways to honor the past, GOOD PEOPLE without remaining trapped in it. I found that by Jan guiding and teaching others to deal with their losses and traumas has also helped to complete This is an essay about me and a disease that took me over when I was a teenager. I have never my own healing. come to terms with it. It is like a war that never If you suffer from PTSD and/or severe anxiety came to a truce, a war within. This disease is not after a loss or trauma, know that you are not common; it has a fancy Greek name, Ankylosing alone. About 8% of the U.S. population will spondylitis, and is a “rheumatic disease,” have this at some point in their lives, according affecting the joints and especially the spine which to the National Center for Post Traumatic Stress gets rigid over time. From the available statistics, Disorder. There are actually approximately 5.2 it strikes mostly men; maybe 90 percent of its million in the U.S. who suffer from this in a given victims are men. year. About 10% of this population is women But I am a woman, and I’ve never stopped and 5% men, which is interesting since we think asking, “Why me?” Soon I turn the page on 65 of PTSD as related to veterans of war, and there years, so I’m dealing with my aging process and are more males in this group. its consequences nowadays, not the disease Another thing to consider is that one person’s itself. trauma is another person’s slightly difficult, but Although the medical profession never could

SPRING 2014 The Compass - Page 37 identify any source for this ankylosing spondylitis aching body, and it wasn’t just the effects of the (stiffening of the spine), it is related to the eyes: an alcohol!!” Finally, hops will make a comeback and inflammation of the iris called “Acute Recurrent dance again, like a forgotten ballerina returning Iritis.” The source of the problem here is the to the stage. ultraviolet rays from the sun. My eyes reacted, Pain awakens the inner voice, and a sensitive became very painful, and I needed special person can hear “the voice of the body.” Nobody prescription eyedrops to clear the condition. likes to hear all that racket and complaining, time If not treated, the lens of my eyes would and again. So one must stifle the outer layer of have fused (glued itself down) onto my eyeball, pain, and listen to a finer frequency, the voice and caused blindness. Luckily for me, my vision that gives suggestions, knowledge, wisdom. wasn’t actually damaged, and finally I learned to It doesn’t happen overnight. It might take a wear brimmed hats - especially early spring and lifetime to fine tune your reception. autumn - to protect from the angle of the sun’s The prescription medications that doctors rays. From the statistics, only about one third of were prescribing for me could have been deadly. people suffering from this form of arthritis also In order to “slow the progression of the disease,” have the iritis. the chemical compounds were suppressing Pain is a selfish bully that is ignorant and the marrow in my bones, the very place which doesn’t admit the full range of damage it is manufactures new red blood cells. They were capable of doing, given time and opportunity. very toxic drugs, and we (the patients) were the My reaction to pain was to ignore it, self-treat experimental guinea pigs. By the time I was in myself with coffee and aspirin, which were my late twenties, doctors prescribing these toxic easily available to me as a teen. We didn’t go substances were required by law to announce to doctors in my family. Huh? Yes! It seems to that “fatal events were known to occur” to those have been some kind of tradition; you had to taking these fine wonderful miracle drugs in their die first, before you got anybody’s attention that given dosages. anything was wrong. The pain lived inside me, So I would walk to the drugstore to get my but nobody could see it. So, I pretended to be new prescription filled, with a sing-song rhyme as normal as I could, and stay active while it was ringing in my head: “Fatal events are known to still possible. occur...” and wonder what in the world I was By my early college years, I learned that beer doing with my life: playing medicine roulette! was a new form of self-medication. Luckily, I In some people a condition called “aplastic tended not to have an addictive personality - I’m anemia” could develop, meaning that no new proud of that - but also I was too underfunded red blood cells would ever be produced, the to indulge in normal addictions like cigarettes or anemia would be irreversible. And I would die. alcohol. But in the bigger picture, I simply could Every year, I would “go cold turkey”: stay not afford to live recklessly; it costs too much to home and go off all medications, for as long as recover from one’s mistakes. I knew that I had I could stand it. Why? I needed to remember. a long way to go. I didn’t want to be a burden I needed to return to “ground zero” and know then; and don’t want to be a burden now. Not fully who I was, once more. I needed to get my on my family, not on society. mind back, because those drugs had a mind- Funny thing about a preference for a beer numbing effect that left me living behind a cloud instead of wine or a cocktail; research is revealing for years at a time. It took about five days to clear that it is the hops, a vining herb that gives beer my system, and by then I would be in bed in a its bitter flavor, and which has a pain-relieving fetal position, with no interest in food or life. Not effect on human joints. There’s a product now getting up to drink water? No need to pee. For available that is an extract made from hops’ me this was like staring the disease in the face: flowers. On reading about it, my inner voice eyeball to eyeball. I needed to find my voice and shouted: “I KNEW it!! Beer gives a relief to my say: I AM NOT that d**mn DISEASE. xxxxxxxxxxxxxxxxxxxxxx

Page 38 - The Compass SPRING 2014 Through the years a lot of information diagnosed with that ugly disease at the age became available for dealing with pain: de- of 19. My bones deteriorated and I’m walking acidify your body through controlling your diet; around on Teflon-coated stainless steel hips that would be number one. Learn which foods from Sweden. Were someone to mention that I affect you adversely and avoid them religiously. look and move kind of like a soldier on patrol, I always got a headache drinking rum, even one well, affirmative! I come equipped with little tin small serving. A friend gets headaches drinking soldier parts! For many years now I’ve been off wine, except one that has no sulfites, a Merlot. all prescription medications, reverting to my little Know thyself. Be good to yourself. Lots of people bottle of aspirin, where each tab costs about two experience pain that is unexplained. cents, rather than go to a doctor and get another It is good to distinguish between sadness, prescription. low energy, pain, and depression. Keep them Oh, I’ve tried those others - ibuprofen, in their separate stalls, recognize and treat each Motrin, acetaminophen - but my body’s voice individually. When I experience low energy, I take says, “No.” Even the anemia which had been a nap. Or revive myself with a cup of caffeinated with me since my teenage years is no more. My tea. You wouldn’t treat a stubbed toe by putting blood is strong, rich; the Red Cross tells me so, clove oil in your ear: don’t treat sadness as every time I give blood. if it were pain. One of the great disasters of I get body-searched every time I pass through overeating or indulging in too much alcohol is airport security, but I do not complain. No, I find that the resulting “fix” confounds your ability to no evidence that anyone ever found a cause for discern the truth of your body’s needs. Even a this disease, why it strikes some people but not low dose of Valium will induce forgetfulness; that others. And yes, medicines did get better over is not a cure. the years, and the deadliest ones were taken off One day walking in New York City, a gentle the market. man gently interrupted me, very cautiously And why am I writing all this? To give voice to gaining my trust and telling me that he had my conviction and share my absolute knowledge some information that might be useful to me, as that I AM NOT THIS D**MN DISEASE. I’m who I he had seen me walking around, and he knew am. There are a lot of disease conditions that can I was in pain. I listened. First of all, just to his happen to a person, but do not make it a part accent - he was from Australia. This was back in of your identity; do not “own” it. It’s kind of like the early 1980s, and he told me of a doctor in Jacob, wrestling with the Angel: don’t give up, Australia who did medical research and proved fight until the final dawn, when your adversary is that there are many people who get relief from forced to surrender and cry, “Uncle!” pain when they stop eating foods related to Jan is from the Midwest where she shovels her own snowy Nightshade. Potatoes, tomatoes, eggplants, path. After a career of editing and proofreading, she finds and sweet green Bell peppers. These four have joy in reading, cooking, quilting, crocheting and gardening alkaline compounds that can be toxic to nerves indoors and out. when they build up in the cells, especially in people with Rheumatoid Arthritis and other HOW TO ACHIEVE BETTER related conditions. The result is pain. Potatoes and tomatoes were the mainstay of QUALITY SLEEP my childhood diet! Along with a few million other by Larry DiBello, RPhd people. And it didn’t take long to learn that the most influential people were ridiculing this idea: There are very simple things doctors. Now, why would a doctor want patients that you can do to improve your to be pain free? Uh, that is... pain free without a quality of sleep. prescription. It has taken me continuous effort to To start with, a good sleep “eat around” those foods, dodging the French environment is very important. fries bullet, staring a potato chip in its seductive Your bedroom should be as dark smiley face and just saying, “No.” and as noise-free as possible. It is better to A lot of years have passed since I was have the room a little too cold rather than too

SPRING 2014 The Compass - Page 39 warm. Light-weight comforters on your bed and course, 50 milligrams. comfortable loose clothing will also help. Benadryl is an antihistamine which is also As far as medication goes, there are very good for runny noses and all allergic reactions simple safe things you can do before resorting like insect stings, hives or rashes like poison to powerful prescription medication. To start ivy. But, it has a great side effect: it makes you with, most experts agree that a glass of water drowsy. It lasts for 8 hours, so it will afford you before retiring is helpful. Even better is a glass this drowsy side effect all night. It also comes of skim milk. It is very high in calcium and also in combinations like Tylenol PM and Advil PM, contains tryptophan which helps your body use which are also good for sleep. The rationale is: the calcium more efficiently. You might also add Benadryl puts you to sleep and the Tylenol or a magnesium supplement. The combination of Advil helps with aches and pains and helps you calcium and magnesium definitely helps with sleep more soundly. achieving good sleep. Another important consideration regarding Our bodies’ natural neurohormone that sleep is that some medications, like stimulants, regulates circadian rhythms is melatonin. interfere with sleep. Ask your doctor or pharmacist Circadian rhythms regulate our waking and if the medications that you’re taking can interfere sleeping cycles. It is essential that these rhythms with sleep. If so take those medications in the are in order for us to feel tired at night and awake morning. during the day. Regular doses of melatonin really Conversely some medications have a side help with getting a good night’s sleep. effect called somnolence (drowsiness). Of course, There are two things you should know about take these medications at bedtime. melatonin. First, melatonin is destroyed in your If you are taking medications that are to help stomach. So when purchasing melatonin you you sleep, you should take them about an hour should get the sublingual form, the kind that before you get into bed because then they will melts in your mouth. have reached the proper blood level and will be Second, melatonin does not work like a working at full strength when you get into bed. sleeping pill. It is a substance that is natural to Perhaps the most important thing about our bodies. It works slowly and must be taken sleep is that to get a good night’s sleep we must regularly. You probably will not feel the effects be physically tired. We don’t get physically tired until you have been taking it a week or two. by sitting in front of the TV for two or three hours Two companies that make sublingual per day. We get physically tired by exercise. melatonin are Natrol and Sundown and can be Moderate exercise within our physical ability purchased in any pharmacy. The 3 milligram certainly will help with getting a good night’s sublingual tablets are usually enough; but, if you sleep. I recommend walking. Wearing good can only find the 5 milligram, that’s fine because shoes, go out your door and walk in a straight melatonin is safe as it occurs naturally in our line until you feel tired, then turn around and go bodies so you can’t take an overdose. back. It’s that simple. Melatonin supplementation is especially Proper sleep is very important to our physical important in anyone over 50 because it seems and mental health. Not getting a good quality that our bodies stop making melatonin after 50. and proper amounts of sleep, besides making us I believe that melatonin supplementation will be tired, can also lead to anxiety and, in the case of helpful with sleep patterns for everyone. people with bipolar disorder, can cause mania Another sleep aid drug that can be purchased or make existing mania worse. in any pharmacy is Benadryl. The chemical name of Benadryl is diphenhydramine. There Larry DiBello is a retired pharmacist who formerly worked are many generics out there and you might see in clinical trials at Eli Lilly & Son. A resident of Springfield, diphen or waldry etc., but they are all the same. PA, he volunteers at the Family Resource Center of Friends The strength available is 25 milligrams; but, it is Hospital of Philadelphia. Call him with any med questions safe to take two tablets or capsules which is, of at 215-514-5110.

Page 40 - The Compass SPRING 2014 WHAT THEY’RE READING of Z” by Stephen Graham Jones - “Purgatory” by Ken Bruen - “We Can Remember It For You Sharon Katz, Executive Director, Psychiatric Wholesale: The Collected Stories of Philip K. Nurse Practitioner, and owner of Collaborative Dick, Volume 5,” - “Only Revolutions” by Mark Care, a full-service psychiatric agency in Z. Danielewski and “Third Rail” by Rory Flynn. Abington and Willow Grove, PA, writes: “I just Craig Slingluff, Jr., poet and surgeon at the finished ‘The Goldfinch’ by Donna Tartt. A lot of University of Virginia, writes: At the moment, I’m good psychological themes, and excellent story, mostly reading scientific papers about cancer a best seller.” immunology, but love reading poetry. Two of my Dan Deming of AWeber.com, “John Dies at favorite poets are Robert Hass and Mary Oliver. the End,” by David Wong. A sci-fi-fantasy with a Recently, I have been reading my wife Kristin lot of pop culture mixed in. I saw the movie and Swenson’s historical fiction novel, in progress, liked it and decided to read the book.” set at the juncture of the fall of Babylon and the Margie Peters, director of the Upper creation of the Persian Empire. Moreland Public Library, in Willow Grove, PA, Man on the Street. An older fellow was writes, “I enjoyed reading this month’s book club walking in the neighborhood. He couldn’t selection of “The Sense of an Ending” by Julian remember the last time he’d read a book. Barnes and am halfway through the classic, “The Not so for Abbe Sherman-Farber from Robe” by Lloyd Douglas. Roslyn, PA, who was waiting in the Willow Ed, The Produce Man, at the Willow Grove Grove Coffee Shop for her husband. Abbe and Giant Supermarket, is a modern man, and a her daughter share books on “Nook.” Abbe is retired math teacher from LaSalle University. He partial to mysteries and loved “Dead Copy” by reads about Astronomy online and also About Making Beer as he is a home brewmeister. Set Kit Frazier and “The Scarpetta Factor” by Patricia me up, Ed, set me up! Cornwell. Denis Hazam, a voracious reader who, with Incidentally, Cornwell just won $32 million in wife Fran, runs a mood disorders group at the a lawsuit she’s been battling for years. The judge Hospital of the University of Pennsylvania, declared that her former financial company had reads no fiction. His current reads are “David been cheating her out of millions of dollars. and Goliath: Underdogs, Misfits, and the Art During the trial, Cornwell’s personal life was of Battling Giants” by Malcolm Gladwell, and laid bare. It was disclosed that she suffers from “The Bully Pulpit: Theodore Roosevelt, William depression and bipolar disorder. Howard Taft, and the Golden Age of Journalism,” 928 pages, by Doris Kearns Goodwin. PURSUE THE WONDERFUL: Aaron Fleisher, attorney in the Civil Rights Division of the US Department of Justice in DC, Wildflowers writes that he read “In the Deep Heart’s Core,” by Carolyn Constable which is by a Yale classmate about his experience teaching in Mississippi. For the train next week, To see a World in a Grain of Sand, he writes, he’s reserved at the library “Baseball as And Heaven in a Wild Flower a Road to God,” by NYU President John Sexton. Hold Infinity in the palm of your hand, Aaron and his wife Anissa – and presumably little And Eternity in an hour. Alec and Laurel – are Phillies’ Fans. William Blake 1757-1827 Christopher O’Riley, of Sagamore Hills, Seems unusual that I write about Wildflowers OH, and host of NPR program “From the Top” in the dead of winter, but anticipating their has plenty of time to read. He flies all over the arrival in Spring, and reflecting on the joy they country to record an hour-long musical program bring helps me through the doldrums of winter. that showcases superior young musicians from 8 Aldo Leopold, a famous conservation writer, to 18. says: “Tell me of what plant birthday, a man takes This prolific reader and Facebook notice, and I shall tell you a good deal about commentator has recently read: “The Gospel his vocation, his hobbies, his hay fever, and the

SPRING 2014 The Compass - Page 41 general level of his ecological education.” secret ground level flower of Wild Ginger. Good By plant birthday he is referring to when a places to search for wildflowers are Bowman’s plant first blooms. For instance in early March, Hill Wildflower Preserve, nature centers, rural the spathes of Skunk Cabbage poke through the roadsides and natural lands trust preserves. winter earth to signal the beginning of spring. You can call ahead to find out what is presently Inside the mottled spathes is the spadix on blooming. which very tiny white flowers bloom. The tepee- Summer meadows yield a profusion of like arrangement of the spathes keep the inside colorful wildflowers. Dame’s Rocket with purple, temperature around 60 degrees so the flowers pink, or white blooms decorates the field in can bloom. Even on a windy 30-degree day early June. Day Lilies and Daisies bring cheer in early March, the internal temperature stays to roadsides. By July, Queen Anne’s Lace and around 60 degrees. The flowers are pollinated Black-eyed Susans are born again. Golden arrays by tiny bees and flies. Skunk Cabbages grow in of Tick-seed Sunflowers and Goldenrods arrive wet marshy areas. We search there for the first at the end of August and remind one that the sign of spring. season of Autumn is approaching. The staff and teachers of Peace Valley Nature I have left my favorite wildflower for the end. Center in Chalfont perform their annual rite of Every fall at the beginning of October, another Spring by traveling to Manderfield Preserve near wildflower enthusiast and I travel to Weisel Youth Trumbauersville, PA, to search for the delicate Hostel in Upper Bucks County to search for the Hepatica flowers. Hepatica grows in deciduous Purple Fringed Gentians. Imagine a wildflower forests and is a Spring Ephemeral which requires blooming in October! The Gentians are gorgeous, sunlight of the leafless forest to bloom. Once voted one of the ten most beautiful wildflowers the leaves are on the trees, the flowers will cease in the country. blooming. We look for the pink, white, or purple On stalks, the Fringed Gentians poke up flowers which poke about two or three inches among the meadow stubble and these violet above the leaf litter and can be found singly or heads about three to five to a stalk are extremely in small bouquets. We delight in finding these lovely. The petals on the flowers are fringed and gems of nature during the first week of April. with dew on the Wildflowers bloom in succession and if you plant present an know the plant birthdays, they are relatively excellent photo easy to find. Planted by God and tended by no opportunity. one, wildflowers are truly one of Nature’s gifts. The only place Marking your wildflower guide as to place and I know to find date they are found will enable you to find them easier in subsequent years. They do not always Fringed Gentians bloom in the exact same spot but should be is in the wet in the vicinity of where they were the previous meadows which year. Picking or removing plants is illegal. Taking are near the Youth photos is a much kinder alternative. Hostel. I do worry After Hepatica, that someone will mow the meadow and then the the gorgeous white whole population of Gentians will be destroyed. Bloodroot appears For ten years we have made our fall pilgrimage on the bank of to view the Fringed Gentians, and the sight of country roads such beautiful flowers enhances our lives. or in the woods. Carolyn Constable is a retired teacher-naturalist at Peace Yellow Trout Lilies Valley Nature Center in Doylestown, PA. Nature is a family appear soon after affair, inherited from her father Roy Imsick. She and nature- Bloodroot followed lover hubby Ron, have a son, Ron Constable, Jr,, who works for the Fish and Wildlife Dept. for the State of Oregon. Ron by pale pink Spring and Carolyn are members of the Scott’s Mountain Hawk Beauties, violets, Virginia Bluebells, and the Watch and count the migrating hawks in the fall.

Page 42 - The Compass SPRING 2014 Kaleidoscope

FOUR BY CYNTHIA MARCOLINA CATHARSIS ROAD Walking outside chilled to the bone, COMMON DENOMINATORS Passing ever changing scenery and Generation apart, Waving to people as I travel Mutual interests. Love of flowers Listening to music. Facing our sun Either planting them in the ground Reminiscing about my past. Or online. A passion for theatre and A sky indescribably blue, Movie scores but different genres. Smelling evergreen trees, hearing wind You preferring fiction. Me? Non. Rushing through their pine needles. I use a word processor for writing A stream running nearby a ditch and Poetry and you do calligraphy. Seeing a red fox decomposing. One day Playing word games on holidays. You Observing a sharp shinned-hawk as he Like Scrabble slow and I love UpWords Watches this rune white crow Fast! We both eat tuna but not onions. Eating a rabbit. Lastly, black bird Mother has coffee black. Daughter with With red wings harbingered spring. Cream. Cynthia drinks dry white wine I started a journey crying and thinking Gloria sweet red. Never agreeing About missed opportunities. My pain being Yet appreciating differences now. A catalyst for change or creativity muse. Silver flecks sparkling in macadam serve SEVEN As tiny mirrors reflecting back sunlight and My tears. Seven is perfect and symbolized pain. Evidence of seven all around beginning I am evolving every day. Because With my date of birth in September I am not who I was yesterday nor who (originally the seventh month). I will be tomorrow. Suffering Helps me grow here on Catharsis Road. Now abounding in dreams as the deep End of a pool, an elevator stop, a shoe size Or exact change. Lastly, I dreamt about Having seven siblings though just one in reality. My mind has a seventh sense it seems- Humor!

SPRING 2014 The Compass - Page 43 SHADES OF LIFE THREE BY DAVID A BARNITZ KIME Blanket of fog Following me now THE SHRINK THAT Seeing it through WOULDN’T GO AWAY My weary eyes Darkness pushing me “If you don’t do what I say Taking over my being you will decompensate Brain is sopping up and decompensate and decompensate All this filthy matter until you become a raving lunatic,” Shades of black he said after entering the room. He reveled in dishing out Peeking through the darkness the latest popular diagnosis, I gain an eyeful of strength the latest remedy Power to fight On the horizon I was a basket case Hold my hand I’ll give him that. I want to become whole But why on earth did he conjure up Shades of Gray Schizoid Personality Disorder, which I saw on my chart Feeling the power and questioned its legitimacy Meeting my demons only to be told Destroying each one “It’s not that bad of a disorder. Clinging to reality Not as bad as Borderline.” My hand can barely Hang on Years later Dr Do Right Shades of Blue as I came to call him popped up at the PMHCA Conference The sun is forming where he did a workshop on A protective robe mood swings which I decided to attend. Wearing it for all to behold He created a new diagnosis called Pushing through the scum Multi-polar, some bullshit to Of depression describe what goes on inside my head My new heart is bursting and hundreds more at this get together. With gladness Later I went up to him Shades of yellow Said “Do you remember me, Dr Do Right?” My faith restored! He bought one of my literary zines Cynthia L. Marcolina is a licensed professional counselor and said “No.” and poet. She’s been married 26 years and has a silky terrier named Gram. She lives in Montgomery County, PA.

Page 44 - The Compass SPRING 2014 I’M ECSTATIC I AM A FRUSTRATED I’m ecstatic. MUSICOLOGIST They put a hot guy on the Price is Right All my relatives say I should go on everybody’s favorite game show. “Name That Tune,” No longer do I have to just peer up a musical game show of the 1970s at super-models that absurdly magically insane decade when I’m riding the stationary bike of fondue, Vietnam and the birth of punk. at the local YMCA. But when push comes to shove When I was four I freeze up I watched everybody’s favorite game show Suddenly Sonic Reducer with Aggie isn’t The Dead Boys tune anymore My English nanny. it’s Richard Hells’ She would give out her own prices Joni Mitchell no longer wrote Woodstock as the early 1970s goodies Adam was never an Ant came up upon the stage and Neil Young was no longer a fondue kit, a Kodak camera, a member of Buffalo Springfield. a portable record player for all those lucky contestants I like to claim to shout out 150, 200 or 1 dollar. I got a jukebox brain With a cranial capacity of Aggie played the lottery every day over a thousand songs. We would walk up to the strip mall on Makefield Road Everywhere I go it plays after the Price is Right relentlessly singing so she could pick out more “I’m worth a million prizes.” unlucky numbers. “I’m waiting for the man.” “If I win,” she’d say, ”Tommy, can you hear me?” “I’ll buy you a motorcycle.” I prefer the crisp sound of vinyl I think of Aggie today as the needle meticulously as the hot guy came out glissandos from groove to blessed groove. with power tools on the display stage. Aggie’s voice said $650. At night I sometimes can’t shut jukebox off. She was about right The damn thing invades while all the actual contestants overbid I’d try counting sheep Hot guy had on overalls. but it will only remind me His muscles were bulging. of Pink Floyds’ Animals. Such nice eye candy And I don’t really care for that album. I wonder if Aggie would approve.

David A. Barnitz Kime of Fairless Hills, PA is an outsider artist whose sculpture, costumes and collage paintings have appeared in galleries throughout Philadelphia, New Jersey and the HAI Gallery in New York City. For over 20 years he has published “Transcendent Visions,” a literary zine that features people in recovery and their allies. His poetry has been published in The Iconoclast, Decades of Confusion, Blackbird and The Compass. He works at the Reach Out Foundation of Bucks County, where he facilitates creative groups for people in recovery.

SPRING 2014 The Compass - Page 45 LIFE WITH BLUE GLASS by Iris Arenson-Fuller

Don’t misunderstand. I love holding a cobalt blue glass full of wine, love how the sun teases and toys with my eyes, even how the dust particles float around, barely visible and evasive, like the truths I used to hold dear that exploded, leaving shrapnel on the heart.

Still I must admire my blue glass collection without getting stuck in the mud of memories, murky, thick, threatening to suck me back to a past that tries to hold me captive forever. I want to fly ahead, to get lost in indigo beams of color dancing madly, sparkling, radiant, as life should be when we love and are loved.

I know what happens in a moment of inattention, when one nymph-like wisp of a negative thought falls across the face, draws a heavy curtain over hopeful eyes and can’t be easily brushed away. how quickly the sunbeam flees, afternoon shadows fall, surround us with barbed wire, with armed sentries that are only ourselves holding us back from living. I have lived enough to know the padlock of the past has a key sitting on a table on the planet of today.

If I peer into the future, make plans that feel solid, that fit my palm as though I chose the perfect apple meant for me from a bowl of fruit, if I begin to count the ways I will win before the popcorn pops in time for a halftime snack, I might claim the gold waiting quietly in the rainbow pot, or I might drop the blue vase expecting to greet a rose, and spend my days picking up a million cobalt shards. my hope, friends, is in this precise moment of warm sun projecting colors on a small spot of golden oak where the black dog is sleeping now.

Iris Arenson-Fuller lives in Bloomfield, CT.

Page 46 - The Compass SPRING 2014 TWO BY RUTH Z. DEMING Oh, the letters they wrote. Dad, I go down on my knees and pray for you every night, Your SUPERBOWL darling daughter Mona. I brought the family bible and read Thy rod and thy staff they SUNDAY XLVIII comfort me. But after all these years I ain’t told no one this, but you’re all alone in the We got here early, helping ourselves world. to the barbeque wings and that sticky-marvelous Ranch dressing, the wife All alone. taking off for the kitchen, but not before I give her a pat on her soft I put three twenties on the coffee table next bee-hind, still my woman after to the salted Planters and tiny rings of -what? – 31 years, one pretzels. “The Seahawks,” I say stringing miscarriage and two live ones some pretzels thru my fingers. leaving their daddy and mama to go up north, hell knows why So! I say taking a long sip of the icy- cold Coors. Let’s take up the God question Bobby! Another Coors and what dyou think? he plops it on the little silver coaster with the ducks flying away You serious, Johnny? We I pat my belly, hardly bigger than just dismantled your president bone by bone on my wedding day, back at and now you want to discuss the Creator? Camp LeJeune, I’m a lineman, climb those poles for Verizon and Laughter and the wife comes out of the kitchen, Man, have I seen some things! her dyed blond hair and green swinging Squirrels fried to a crisp – they eat them here earrings lookin good. Babe, c’mon sit here in Houston, but not me, no sirree – but I on your ole man’s lap. Why, you’re just plain love my job, refused to make more dough drunk, she laughs and plops that soft ass and be a boss – I’m just a member of the on my legs and gives me a nice smooch on team, like Manning and Sherman – wonder the lips. how many folks are gonna name their kid Peyton? That’s Americans for you. God bless How many more minutes? asks Rodge, in the America. swiveling purple chair, wearing an A & M sweatshirt. Sure I voted for Obama, in fact we’re talking about him now, his State of the Union Speech Tee-off, says my wife, is in sixteen minutes. last Tuesday, the boys say he promised us Kick-off, I mean. everything and delivered us nothing, but, hell, he’s a good man, got us outa one war; I lay down my life and the lives of my family in the Invasion of whoever heard of Grenada?

SPRING 2014 The Compass - Page 47 WADE IN THE WATER DRY Back in the den, the room where they lived, The fenced-in yard bowls of pretzels was black with birches and salted nuts had been and pines that set out on the coffee table, whisked the sky. my ginger ale Birdfeeders freshened and zoomed up stilts replaced on its coaster. waiting for the quiver of arrival. Ron, the planter of trees, All this from the kitchen window, lay sunk in the blue shine my first visit with Simon’s kin, of his recliner, postponed as long as I dared. an architectural wonder Then one day we dressed supporting the man and went. and his white newsboy shorts. The company he worked for, His sister Dot going on forty-one years, welcomed me, had forgotten how to make money. the woman who saved her brother Ron was calm, telling us how from the shudder of divorce. nothing worked anymore. I moved around the kitchen The bankers hovered like crows. with great familiarity, spotting in the corner Ron was a fisherman, a plastic bowl visiting rocky shores and stuck with the last bits sand-filled slopes, walking of untasted meat. alone in cold misty waters Oh, laughed Dot, untying her apron, where fingers froze, Old Suze never finished her lunch, cramped shut like claws. and told me in high-pitched trills And wore those waders. where to find her, the cat they rescued from a I asked Ron what waders were. turnpike rest stop Like overalls, he said. the year Ron put in You pull them up past your waist, then the elms. wade through the water dry.

I walked across the Ah! living room I imagined Ron the sofa and chairs pulling on his extra-large curved like motionless dolphins waterproof trousers, waiting for something to happen soft as deerskin leggings, and parted the gauzy curtains. carrying him, There she was, and his legs, dry as fishbones, Miss Suze, into the reclining in the sun, sweet poised as a woman in furs. dimly lit She quivered at my arrival. waters of night become morning.

Ruth Z. Deming was a runner-up Poet Laureate of Montgomery County, PA. Her poems have appeared in the Bellowing Ark, Mad Swirl, Metazen, and other venues. Her first poem, written at age 8, was “The Mullagering,” about a goblin who buries its victims alive, after which they are transformed into new beings.

Page 48 - The Compass SPRING 2014 THREE BY MARTHA HUNTER HIS JOURNEY BEGINS

MARTHA The boy’s bags have been packed for a long . time. Glimpses of Memory Overwhelmed? Was that really me? Too sensitive for this world? That woman who lives in the mists of memory, Ground down by emotions not under his control? A person so different from my present self? He buys the means to the end from a Walmart, She - Who toiled at her sewing machine for days The two-week waiting period of no consequence. on slight hours of sleep, What’s two more weeks in light of eternity? gallons of Coke Wife away, children sleeping deeply and Ativan chewed like antacids As loved, secure children do, Whose creativity was at once He lies down on his bed, wonderful as it was confusing. Careful not to soil the comforter with his Who made Himalayas out of creek banks. Dirty shoes, Who punished harshly His wife hates that. those she should have nurtured, He spreads a towel on the pillowcase loving them but unable to separate As if that scrap of cloth will contain the after her own sad experience effects. from her mini-me’s’ Maneuvers the relief of choice into position, Whose obsessions sent her stalking Says a prayer, unable to resolve the blips Takes a breath in the flow of life And flies away into eternity. And finally, by the mercy of God, Off on a new adventure, a day late and a dollar short, His pain behind him, dragged kicking and screaming His loved ones’ pain begun. to a diagnosis, Refusing to admit that I was ‘that’ person - The one everyone tries to avoid lest they be caught in her ranting. Walking the long, frustrating road of drug trials, Periodically quitting the whole ‘stupid thing,’ Writing and revising reams of Suicide notes and angry journal entries, Talk therapy that sought to Untangle the hopelessly knotted Threads of the past. That woman still lives in the chance meetings of people from ‘back then’ whose words greet me sweetly but whose body language asks if time has changed the crazy girl. There is fear in going forward lest I am not the ‘new’ person I think I am. Forgiving others is easy compared to Forgiving myself. And yet, Because I have chosen to go on with life, I do forgive.

SPRING 2014 The Compass - Page 49 A PARENT’S PRAYER In January of 2000 I had been visiting my aging parents to help with chores and errands. Every family has that one child who lives We had our endless cups of tea, Dad’s extra sharp in opposition to every physical, spiritual and cheddar cheese sandwiches, and Pennsylvania emotional tenet of communal life. In the Dutch spaetzle. I played their Hammond Organ Macdonald family, that was me. Black was white, and we sang old hymns. When I was ready to rules were suggestions, God was a boring saga leave, mother said, “Daddy, would you bless told by Sunday School teachers and prayer took Martha Jeanne before she leaves?” He laid up valuable minutes that could better be spent his hands on my head and prayed a patriarch’s thinking up mischief. Life was an adventure for prayer over me as he had a thousand times, but this extroverted wild thing and faith practice was this time, it felt different. There was an urgent like a fly buzzing over a picnic lunch. spirit to it. And indeed, by midnight he was I lived in an era when parents took time with Home, my last memory, my father’s prayer. bedtime rituals. A story, some comforting words Mother followed him four months later. As and prayers. Getting me settled was a chore. she declined and we counted down the days, we My brain was moving so fast and monsters lurked shared a lifetime of memories and bittersweet in every corner of my racing imagination. But prayers, knowing these were our last hours mother was up to it. A warm bath, a whole grain together. On the afternoon of her last day, snack, story and then… the prayer routine. Every mother roused from her twilight sleep, gazed at night she would point to the painting above my me, and said my name. I held her hands, those bed, of Jesus Knocking at the Heart’s Door and same hands that had cared enough to hold me say, “Martha Jeanne, He wants to come into down and draw me to God, and sent her off on your heart. Won’t you let Him in?” And every the wings of a prayer, committing her to the next night I would shout, “No!” Then, she would lay steps of her continuing journey. gentle hands on me and begin a prayer. As I Mom and Dad have been gone for many thrashed back and forth her gentle touch would years now. The painting of Jesus at the Heart’s become a grip and finally, full-fledged restraint. Door hangs in my bedroom watching over me as She was going to get those prayers in, not to be I sleep. I’ve almost forgotten the sound of their right, but because it was good for me to know voices and the fragrances of her Lilac sachet and that somebody bigger was in charge of my fitful his Old Spice. But I’ve never forgotten those sleep. prayers that have followed me from disgruntled I didn’t want my parents’ prayers. And yet, child to faithful grandmother and will one day I received them grudgingly all my life, when lead me Home for the grand reunion. leaving for school, going on a date or when a broken heart sent me to playing sad songs on my Martha Hunter is a retired teacher. She works as a substitute aide in the Upper Moreland School District and hi-fi. Through marriage, through childbearing, is also a pastoral counselor. A resident of Willow Grove, one or the other of them would pray a blessing PA, she writes Biblical fiction and poetry. over me and send me on my way with hope and lightness.

Page 50 - The Compass SPRING 2014 THE CHEERLEADER By Carly Brown

For those that are able to write, I will be A cheerleader

For those who are able to string together words making sense, I will be A cheerleader

For those who have ideas and are able to put them on paper, I will be A cheerleader

Because I know that at some point, I will be able to write, Able to string words making sense together, And have wondrous ideas that just flow upon the page

I know my time will come But for now, I am content, to be a Cheerleader

Carly Brown has worked as a salesperson for Lazy Boy Furniture and runs an area chapter of TOPS, Take Off Pounds Sensibly. Now retired, Carly now has more time to play with her grandson, Cooper, and to write. She and husband Charlie live in Willow Grove, PA.

THREE BY ALLAN M. HELLER

HAVE YOU LOST YOUR MIND?

Some mornings my legs are a pair of splintery old telephone poles Without benefit of creosote As I slough through the day Whose hours are sheets of ice beneath my clay feet While my back, refusing to be outdone by less-than-limber lower limbs Seizes into a slab of sheetrock. An odd combination, I admit. I feel like a piece of abstract art. Art that I would be hard-pressed to create With my rubber band arms and hands And 40-watt eyeballs. “What an awful thing to bear,” I hear them say. “Even if it is only four days out of seven. “Have you lost your mind yet?” they politely inquire. What can I do but smile And leave them wondering? ABABABABABABABABABABABABABABABABAB

SPRING 2014 The Compass - Page 51 WHEN THE GOING GETS TOUGH

When the going gets tough, the dumb ones get tougher Like a pair of bull rams knocking their heads together for hours Rendering both of them senseless Which is redundant, of course.

When the going gets tough, I become a lightning bolt Meandering down the dark sky Seeking the path of least resistance While stupid thunderheads bluster and rumble Until they are totally spent Dissipating into the vapors from which they emerged.

A famous Samurai, who boasted of his many kills Found the form of a feather more formidable Than unrestrained ferocity And struck with perfect precision Only after his opponents had exhausted themselves Trying to smite a floating feather.

Even Alexander didn’t bother With trying and prying and untying Some ridiculous knot.

These poems were originally published in Helium.com.

Page 52 - The Compass SPRING 2014 I SPOKE TO ED GALING

I spoke to Ed Galing the night that he passed He was feeling depressed, even though he’d amassed An impressive portfolio throughout his life. He was plagued by ill health, and the loss of his wife. “Your poems are priceless,” I said to my friend Not knowing, of course, that tonight was the end. Wheelchair-bound and half-blind, Ed still wrote every day On a manual typewriter; that was his way. He tasted the hard life, walked down the mean streets. Overall, Ed’s achievements outweighed his defeats. Homelessness, poverty, he knew them all Saw the wake of world war, and sights to appall Like a camp liberated, whose smoldering fires Brought tears to a young soldier’s eyes, and desires To do terrible things to the terrible men Who blithely destroyed futures that might have been. 97 long years produced volumes of verse. For a “poor, simple poet,” he could have done worse. We said our goodbyes, and he promised he’d write And then God called him home in the wee hours of night. But Ed made me a promise, and he did not fail: Two days later, his letter arrived in the mail.

This poem appeared in the Jan.12 issue of The Public Spirit newspaper of Hatboro, PA, where Ed Galing had been the Poet Laureate.

Allan M. Heller has published four non-fiction books and numerous short stories and poems. He lives in Hatboro, PA, with his lovely wife, Tatiana, and their wonderful cat, Rocky.

SPRING 2014 The Compass - Page 53 THREE BY LINDA BARRETT She takes our coats Places them in the dining room’s closet LOBSTERS Kathy deserves the kudos For suggesting Brian drive They sit in the cramped corners out to Acorn Lane, of the water tank Pick Mother and me up face each other Brave the traffic armored claws bound To celebrate this gilded day with thick rubber bands With people offering These shelled warriors Sincere love, compassion take on boxer’s stances Outside of just turkey, wait their chance Stuffing and gravy. to attack each other by impromptu bouts They step over one another NEWTOWN REQUIEM pick fights for dominance of their watery ring Let this day approach silently Some desperate crustaceans bow our heads again decide to make their escape try to remember what happened reach out for the tank’s top how did this become a tragedy but fall over backwards should you blame his mother onto each other even the broken mental health care system? Those lucky ones blame the violent video games usually win the second amendment when the Seafood Man badly controlled gun control laws? in his white coat No. pulls them out Remember those lives makes the champions the ones cut off someone’s dinner. before they had a chance to bloom Recall only the bravery A THANKSGIVING of both victims great and small Consider them at the end THANK YOU of what remained Dear Waldenbergers, in Pandora’s box Thank you for a wonderful thanksgiving Hope’s great green gem It’s always a pleasure left sparkling in the box’s bottom Spending Turkey Day with you Reach in and take it out When we enter, plant it, knowing that Joe greets us at the door it will grow, covering over With his burly bear hugs what Evil left behind. Lucie comes out of the kitchen, Her vivacious personality Reaching us before she does Linda Barrett is an award-winning short-story writer. She works at the Giant Food Store and lives in Abington, PA. mmmmmmmmmmmmmmmmmmm

Page 54 - The Compass SPRING 2014 TWO POEMS BY FRANK KELSO WOLFE

ADL’s

Today I shall cut myself shaving, and slap on some Aqua-Velva, just so I’ll remember the sting. Last night I brushed my teeth, then drank a glass of orange juice, so as to not take sweetness for granted. My bed, less and less a comfort, I make it every day despite the struggle of standing, finding pleasure in things well ordered. The delivery guy has become a friend, and I tip him well. He brings my lunch to my room, stringing out an unsustainable situation. I might never leave my bed, surrounded by my social media, and joy when sunlight streams through my big bay windows, sequestered except when nature calls, or I must have chocolate. Depending on the kindness and/or love of others, I’ve realized it’s whatever gets you through the day, and the only absolutely necessary activity of daily living is desiring to live.

ME AND DAN

Frustration, always the friend never the lover. Joy, at your scratchings and smearings on paper and cloud. Pain, within and without circling, clutching, coughing. You played the cards dealt you, you fought it longer than mere mortals. ill, peculiar, juxtapositions, pills laughing, limitless, medicated and burning. Ideas, desperate hours, fantasy and fears. Frank Wolfe writes that he “walks the line between Struggling, a brother despair and unshakable optimism.” He spends most of like because you’re broken but his time these days in his “fortress of solitude (bedroom), Love, with attempting to avoid further pain” – he suffers from chronic perfect vision, silly, suffering pain. Frank has lived in Royersford, PA, in the same home non-content or given up. Held for more than 35 years. An award-winning poet, Frank’s many paintings can be seen on his Facebook page, Frank like a dull razor. K. Wolfe Artist.

SPRING 2014 The Compass - Page 55 TWO POEMS FROM FAREWELL BY CRAIG L. SLINGLUFF Not liberated, really, CARLOS not like the end of exams and the beginning of June, the trees full of green, buds pregnant, If I knew, the air warm over her shoulders when I heard you’d called as she runs with her girlfriends about him -- from school If it was no surprise – to home If it was even for the whole summer the expected end to his grief – so big, like the ocean, its end too far away to be seen and if I had talked about or believed. how distant he seemed when I spoke with him again Instead, like the plummet a year ago, before the chute opens, nothing and didn’t talk to him then but the soft air around, about his addiction no one telling her what to do, or his recovery no job except to pull the cord, or his love of teaching everything so far away, or his love of men the plane that was home or whether he was able speeding away above to give his heart too small to make out enough again the tiny face looking down and didn’t tell him I, to be sure she is all right, at least, the ground all green forgave him and the water smooth. for his addictions, She isn’t sure the chute will open for not being able to live or that she will land safely. up to his own expectations, She just keeps looking around cradled in the large warm air remembering his touch, If I knew all that and yet, and how his gaunt face gleamed. remembering my regret at not saying enough to my grandfather as he BIO: Craig L. Slingluff, Jr. is the Joseph Helms Farrow lay mute and dying, Professor of Surgery at the University of Virginia. His surgical knowing the chance would not come again, practice focuses on care of patients with melanoma, and he is active in cancer research directed at improving the immune and remembering my promise then response to cancer. Born in 1958, he studied poetry writing to transform it forward, at the University of Virginia under Gregory Orr and Carolyn Forche. His work has appeared in the “Virginia Quarterly Review.” He lives in Charlottesville, VA. how could he Says Craig about his writing: “I developed a strong interest in have felt so alone? reading and writing poetry when in college at the University of Virginia, and found a very vibrant and supportive literary community in Charlottesville then, and since. Reading and June 16 2010 writing poetry helps me to appreciate important moments in my life and to manage personal challenges. I write sporadically Carlos Gomez killed himself over the weekend, June 12,13 and mostly when something bubbles up in my mind, needing to be written. I love reading poetry; its lessons transport me, helping me to appreciate moments, and to step out of my own psyche, to appreciate our world through the eyes of others.

Page 56 - The Compass SPRING 2014

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